NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA.
NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA; University of Chicago Pritzker School of Medicine, 5841 S Maryland Ave, Chicago, IL 60637, USA.
Am J Emerg Med. 2021 Sep;47:239-243. doi: 10.1016/j.ajem.2021.04.050. Epub 2021 Apr 19.
The global healthcare burden of COVID-19 continues to rise. There is currently limited information regarding the disease progression and the need for hospitalizations in patients who present to the Emergency Department (ED) with minimal or no symptoms.
This study identifies bounceback rates and timeframes for patients who return to the ED due to COVID-19 after initial discharge on the date of testing.
Using the NorthShore University Health System's (NSUHS) Enterprise Data Warehouse (EDW), we conducted a retrospective cohort analysis of patients who were tested positive for COVID-19 and were discharged home on the date of testing. A one-month follow-up period was included to ensure the capture of disease progression.
Of 1883 positive cases with initially mild symptoms, 14.6% returned to the ED for complaints related to COVID-19. 56.9% of the mildly symptomatic bounceback patients were discharged on the return visit while 39.5% were admitted to the floor and 3.6% to the ICU. Of the 1120 positive cases with no initial symptoms, only four returned to the ED (0.26%) and only one patient was admitted. Median initial testing occurred on day 3 (2-5.6) of illness, and median ED bounceback occurred on day 9 (6.3-12.7). Our statistical model was unable to identify risk factors for ED bouncebacks.
COVID-19 patients diagnosed with mild symptoms on initial presentation have a 14.6% rate of bounceback due to progression of illness.
COVID-19 对全球医疗保健的负担持续增加。目前，关于在出现轻微症状或无症状的情况下到急诊部（ED）就诊的患者疾病进展情况以及住院需求的信息有限。
本研究确定了因 COVID-19 在最初检测日出院后再次返回 ED 的患者的反弹率和时间框架。
使用 NorthShore 大学卫生系统（NSUHS）企业数据仓库（EDW），我们对在最初检测日检测出 COVID-19 并出院回家的患者进行了回顾性队列分析。包括一个为期一个月的随访期，以确保能捕捉到疾病进展。
在 1883 例最初有轻度症状的阳性病例中，有 14.6%的患者因与 COVID-19 相关的投诉返回 ED。在轻度症状反弹的患者中，56.9%在返回就诊时出院，39.5%入院，3.6%入住 ICU。在 1120 例最初无症状的阳性病例中，只有 4 例（0.26%）返回 ED，只有 1 例患者住院。最初检测的中位数发生在疾病的第 3 天（2-5.6），ED 反弹的中位数发生在第 9 天（6.3-12.7）。我们的统计模型无法确定 ED 反弹的危险因素。
最初表现为轻度症状的 COVID-19 患者，因病情进展而再次返回 ED 的比例为 14.6%。
