土耳其一家三级保健大学医院出院的 COVID-19 患者 30 天再入院率：一项观察性、单中心研究。
Thirty-day readmission rate of COVID-19 patients discharged from a tertiary care university hospital in Turkey: an observational, single-center study.
机构信息
Faculty of Medicine, Department of Internal Medicine, Section of General Internal Medicine, Hacettepe University, Sıhhiye, Ankara, 06430, Turkey.
Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Hacettepe University, Sıhhiye, Ankara, 06430, Turkey.
出版信息
Int J Qual Health Care. 2021 Feb 20;33(1). doi: 10.1093/intqhc/mzaa144.
BACKGROUND
The 30-day readmission rate is an important indicator of patient safety and hospital's quality performance. In this study, we aimed to find out the 30-day readmission rate of mild and moderate severity coronavirus disease of 2019 (COVID-19) patients discharged from a tertiary care university hospital and to demonstrate the possible factors associated with readmission.
METHODS
This is an observational, single-center study. Epidemiological and clinical data of patients who were hospitalized with a diagnosis of COVID-19 were retrieved from a research database where patient information was recorded prospectively. Readmission data were sought from the hospital information management system and the National Health Information System to detect if the patients were readmitted to any hospital within 30 days of discharge. Adult patients (≥18 years old) hospitalized in COVID-19 wards with a diagnosis of mild or moderate COVID-19 between 20 March 2020 (when the first case was admitted to our hospital) and 26 April 2020 were included.
RESULTS
From 26 March to 1 May, there were 154 mild or moderate severity (non-critical) COVID-19 patients discharged from COVID-19 wards, of which 11 (7.1%) were readmitted. The median time of readmission was 8.1 days (interquartile range [IQR] = 5.2). Two patients (18.1%) were categorized to have mild disease and the remaining 9 (81.9%) as moderate disease. Two patients who were over 65 years of age and had metastatic cancers and hypertension developed sepsis and died in the hospital during the readmission episode. Malignancy (18.7% vs. 2.1%, P = 0.04) and hypertension (45.5% vs. 14%, P = 0.02) were more common in those who were readmitted.
CONCLUSIONS
This is one of the first studies to report on 30-day readmission rate of COVID-19 in the literature. More comprehensive studies are needed to reveal the causes and predictors of COVID-19 readmissions.
背景
30 天再入院率是衡量患者安全和医院质量绩效的重要指标。本研究旨在了解从一家三级教学医院出院的轻度和中度 2019 年冠状病毒病（COVID-19）患者的 30 天再入院率，并展示与再入院相关的可能因素。
方法
这是一项观察性、单中心研究。从前瞻性记录患者信息的研究数据库中检索因 COVID-19 住院且诊断为 COVID-19 的患者的流行病学和临床数据。从医院信息管理系统和国家健康信息系统中检索再入院数据，以检测患者是否在出院后 30 天内再次入住任何医院。纳入 2020 年 3 月 20 日（首例患者入院时）至 2020 年 4 月 26 日期间因轻度或中度 COVID-19 入住 COVID-19 病房的 18 岁及以上成年患者。
结果
3 月 26 日至 5 月 1 日期间，共有 154 例轻度或中度（非危重症）COVID-19 患者从 COVID-19 病房出院，其中 11 例（7.1%）再次入院。再入院的中位时间为 8.1 天（四分位距 [IQR] = 5.2）。2 例（18.1%）患者被归类为轻度疾病，其余 9 例（81.9%）为中度疾病。2 例年龄超过 65 岁且患有转移性癌症和高血压的患者发生脓毒症并在再次入院期间死亡。恶性肿瘤（18.7% vs. 2.1%，P = 0.04）和高血压（45.5% vs. 14%，P = 0.02）在再入院患者中更为常见。
结论
这是文献中首次报道 COVID-19 30 天再入院率的研究之一。需要更全面的研究来揭示 COVID-19 再入院的原因和预测因素。
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