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评估 COVID-19 住院后 30 天再入院率、时间、原因和预测因素。

Assessment of thirty-day readmission rate, timing, causes and predictors after hospitalization with COVID-19.

机构信息

From the, Division of Cardiology, Department of Medicine, New York-Presbyterian Queens, Flushing, NY, USA.

Graduate School of Biomedical Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

出版信息

J Intern Med. 2021 Jul;290(1):157-165. doi: 10.1111/joim.13241. Epub 2021 Feb 5.

Abstract

BACKGROUND

There are limited data on the characteristics of 30-day readmission after hospitalization with coronavirus disease 2019 (COVID-19).

OBJECTIVES

To examine the rate, timing, causes, predictors and outcomes of 30-day readmission after COVID-19 hospitalization.

METHODS

From 13 March to 9 April 2020, all patients hospitalized with COVID-19 and discharged alive were included in this retrospective observational study. Multivariable logistic regression was used to identify the predictors of 30-day readmission, and a restricted cubic spline function was utilized to assess the linearity of the association between continuous predictors and 30-day readmission.

RESULTS

A total of 1062 patients were included in the analysis, with a median follow-up time of 62 days. The mean age of patients was 56.5 years, and 40.5% were women. At the end of the study, a total of 48 (4.5%) patients were readmitted within 30 days of discharge, and a median time to readmission was 5 days. The most common primary diagnosis of 30-day readmission was a hypoxic respiratory failure (68.8%) followed by thromboembolism (12.5%) and sepsis (6.3%). The patients with a peak serum creatinine level of ≥1.29 mg/dL during the index hospitalization, compared to those with a creatinine of <1.29 mg/dL, had 2.4 times increased risk of 30-day readmission (adjusted odds ratio: 2.41; 95% CI: 1.23-4.74). The mortality rate during the readmission was 22.9%.

CONCLUSION

With 4.5% of the thirty-day readmission rate, COVID-19 survivors were readmitted early after hospital discharge, mainly due to morbidities of COVID-19. One in five readmitted COVID-19 survivors died during their readmission.

摘要

背景

关于新冠肺炎(COVID-19)住院后 30 天再入院的特征,目前数据有限。

目的

检查 COVID-19 住院后 30 天再入院的发生率、时间、原因、预测因素和结局。

方法

从 2020 年 3 月 13 日至 4 月 9 日,纳入所有因 COVID-19 住院并存活出院的患者进行这项回顾性观察性研究。多变量逻辑回归用于确定 30 天再入院的预测因素,限制性立方样条函数用于评估连续预测因素与 30 天再入院之间的线性关系。

结果

共纳入 1062 例患者进行分析,中位随访时间为 62 天。患者的平均年龄为 56.5 岁,40.5%为女性。研究结束时,共有 48 例(4.5%)患者在出院后 30 天内再次入院,中位再入院时间为 5 天。30 天再入院的最常见主要诊断是低氧性呼吸衰竭(68.8%),其次是血栓栓塞(12.5%)和败血症(6.3%)。与血清肌酐水平<1.29mg/dL 的患者相比,指数住院期间血清肌酐峰值≥1.29mg/dL 的患者 30 天再入院的风险增加 2.4 倍(调整后的优势比:2.41;95%CI:1.23-4.74)。再入院期间的死亡率为 22.9%。

结论

COVID-19 幸存者的 30 天再入院率为 4.5%,在出院后早期再次入院,主要是由于 COVID-19 的并发症。五分之一再入院的 COVID-19 幸存者在再入院期间死亡。

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