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新冠病毒感染出院患者的再次入院情况

Hospital Readmissions of Discharged Patients with COVID-19.

作者信息

Parra Lina Marcela, Cantero Mireia, Morrás Ignacio, Vallejo Alberto, Diego Itziar, Jiménez-Tejero Elena, Múñez Elena, Asensio Ángel, Fermández-Cruz Ana, Ramos-Martinez Antonio

机构信息

Servicio de Medicina Preventiva, HU Puerta de Hierro-Majadahonda, Madrid, Spain.

Servicio de Medicina Interna, HU Puerta de Hierro-Majadahonda, Madrid, Spain.

出版信息

Int J Gen Med. 2020 Dec 2;13:1359-1366. doi: 10.2147/IJGM.S275775. eCollection 2020.

Abstract

OBJECTIVE

To analyse the rate of occurrence and the clinical variables associated with readmission of patients who had previously been discharged after admission for COVID-19.

SETTING

University hospital in Madrid (Spain).

PARTICIPANTS

Sixty-one patients (74% male) who presented COVID-19 were readmitted during the 3 weeks after discharge from hospital.

INTERVENTIONS

Nested case-control study paired (1:1 ratio) by age, sex and period of admission.

OUTCOME MEASURES

Rate of readmission rate of patients discharged after suffering COVID-19 and identification of the clinical variables associated with it.

RESULTS

Out of 1368 patients who were discharged during the study period, 61 patients (4.4%) were readmitted. Immunocompromised patients (N=10.2%) were at increased risk for readmission (p=0.04). There was also a trend towards a higher probability of readmission in hypertensive patients (p=0.07). Cases had had a shorter hospital stay and a higher prevalence of fever during the 48 hours prior to discharge. There were no significant differences in oxygen levels measured at admission and discharge by pulse oximetry intra-subject or between the groups. Neutrophil-to-lymphocyte ratio at hospital admission tended to be higher in cases than in controls (p=0.06). Neither glucocorticoids nor anticoagulants prescribed at hospital discharge were associated with a lower readmission rate. Patients who were readmitted due to a thrombotic event (8 patients, 13.1%) presented a higher level of D-dimer at discharge of initial admission.

CONCLUSION

The rate of readmission after discharge from hospital for COVID-19 was low. Immunocompromised patients and those presenting with fever during the 48 hours prior to discharge were at greater risk of readmission to hospital.

摘要

目的

分析先前因 COVID-19 入院后出院的患者再次入院的发生率及相关临床变量。

背景

西班牙马德里的大学医院。

研究对象

61 例出现 COVID-19 的患者在出院后 3 周内再次入院(男性占 74%)。

干预措施

按年龄、性别和入院时间进行 1:1 配对的巢式病例对照研究。

观察指标

COVID-19 后出院患者的再次入院率以及与之相关的临床变量识别。

结果

在研究期间出院的 1368 例患者中,61 例(4.4%)再次入院。免疫功能低下患者(10.2%)再次入院风险增加(p = 0.04)。高血压患者再次入院的可能性也有升高趋势(p = 0.07)。病例组患者住院时间较短,出院前 48 小时内发热患病率较高。组内或组间经脉搏血氧饱和度测定的入院和出院时氧水平无显著差异。病例组入院时中性粒细胞与淋巴细胞比值往往高于对照组(p = 0.06)。出院时开具的糖皮质激素和抗凝剂均与较低的再次入院率无关。因血栓事件再次入院的患者(8 例,13.1%)首次入院出院时 D-二聚体水平较高。

结论

COVID-19 患者出院后的再次入院率较低。免疫功能低下患者以及出院前 48 小时内发热的患者再次入院风险更高。

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