Leijte Wouter T, Wagemaker Nicolaas M M, van Kraaij Tom D A, de Kruif Martijn D, Mostard Guy J M, Leers Math P G, Mostard Rémy L M, Buijs Jacqueline, van Twist Daan J L
Zuyderland Medisch Centrum, afd. Longziekten, Sittard/Heerlen.
Zuyderland Medisch Centrum, afd. Interne Geneeskunde, Sittard/Heerlen.
Ned Tijdschr Geneeskd. 2020 Nov 19;164:D5423.
Hospitalization for corona virus disease 2019 (COVID-19) may be followed by complications after discharge. We aimed to evaluate mortality, readmission rate, and readmission characteristics after hospitalization with COVID-19.
A retrospective cohort study METHODS: Inclusion of all patients hospitalized for COVID-19 between March 1, 2020, and June 1, 2020 in Zuyderland Medical Centre, The Netherlands. Main outcome measures were mortality and readmission after hospitalization. Univariate and multivariate regression analysis were performed to identify risk factors for death and readmission.
A total of 769 patients hospitalized with COVID-19 (mean age 70 ± 14 years; 39% female) were included in the study. In-hospital mortality was 22.4% , as such 596 patients were discharged alive and followed after discharge with a median of 80 days (IQR 66-91). Total mortality after discharge was 6.4% (n=38) and readmission rate was 11.7% (n=70). Main reasons for readmission were respiratory insufficiency (31%), arterial and venous thrombotic events (16%) or related to a chronic comorbidity (14%). Mortality rates were higher in older patients and patients who experienced delirium during hospital stay. Risk factors for readmission were male sex, discharge to a long-term care facility and COPD.
1 out of 6 COVID-19 positive patients died or was readmitted after discharge. This shows an ongoing vulnerability of COVID-19 patients. Physicians and policy makers should consider this high rate when making decisions on discharge, hospital-capacity planning, and patient monitoring after discharge.
2019年冠状病毒病（COVID-19）患者住院后可能会出现出院后并发症。我们旨在评估COVID-19住院后的死亡率、再入院率和再入院特征。
一项回顾性队列研究
纳入2020年3月1日至2020年6月1日在荷兰祖伊德兰德医疗中心因COVID-19住院的所有患者。主要结局指标为住院后的死亡率和再入院率。进行单因素和多因素回归分析以确定死亡和再入院的危险因素。
本研究共纳入769例因COVID-19住院的患者（平均年龄70±14岁；39%为女性）。住院死亡率为22.4%，因此596例患者存活出院，并在出院后进行随访，中位随访时间为80天（四分位间距66-91天）。出院后总死亡率为6.4%（n=38），再入院率为11.7%（n=70）。再入院的主要原因是呼吸功能不全（31%）、动静脉血栓形成事件（16%）或与慢性合并症相关（14%）。老年患者和住院期间出现谵妄的患者死亡率较高。再入院的危险因素为男性、出院后入住长期护理机构和慢性阻塞性肺疾病（COPD）。
6例COVID-19阳性患者中有1例在出院后死亡或再次入院。这表明COVID-19患者持续存在易感性。医生和政策制定者在做出出院决策、医院容量规划和出院后患者监测时应考虑到这一高比率。
