Department of Hospital Medicine, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.
Department of Internal Medicine, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.
Infect Dis (Lond). 2021 Oct;53(10):800-804. doi: 10.1080/23744235.2021.1924398. Epub 2021 May 8.
Limited studies have explored post-discharge outcomes following Coronavirus Disease 2019 (COVID-19) hospitalisation. We sought to characterise patients discharged following a COVID-19 hospitalisation within a large integrated health system in the United States.
We performed a retrospective study of 2180 COVID-19 patients discharged between 1 April 2020 and 31 July 2020. The primary endpoint was all-cause observation stay or inpatient readmission within 30 days from discharge. Bivariate and multivariable logistic regression analyses were performed to estimate the association between key socio-demographic and clinical characteristics with risk of 30-day readmission.
The 30-day readmission rate was 7.6% ( = 166); 30-day mortality rate was 1% ( = 19). Most readmissions were respiratory-related (58%) and occurred at a median time of 5 days post discharge. Adjusted models showed that prior hospitalisations (Odds Ratio = 2.36, [95% Confidence Interval: 1.59-3.50]), chronic pulmonary disease (1.57 [1.09-2.28]), and discharge to home health (1.46 [1.01-2.11]) were significantly associated with 30-day readmission. Longer duration from diagnosis to index admission was borderline associated with lower odds of readmission (0.95 [0.91-1.00]).
Readmission and mortality rates for COVID-19 following discharge are low. Most readmissions occur early and are due to respiratory causes and may reflect the prolonged acute disease course.
关于新冠肺炎(COVID-19)住院患者出院后的转归,目前仅有少量研究进行了探讨。本研究旨在对美国一家大型综合医疗系统中 COVID-19 出院患者的特征进行描述。
我们对 2020 年 4 月 1 日至 7 月 31 日期间出院的 2180 例 COVID-19 患者进行了回顾性研究。主要终点是出院后 30 天内因任何原因再次住院或再次入院。采用二变量和多变量逻辑回归分析,评估关键社会人口学和临床特征与 30 天再入院风险之间的关联。
30 天再入院率为 7.6%(166 例);30 天死亡率为 1%(19 例)。大多数再入院与呼吸系统相关(58%),出院后中位时间为 5 天。调整后的模型显示,既往住院史(优势比=2.36,95%置信区间:1.59-3.50)、慢性肺部疾病(1.57,1.09-2.28)和出院至家庭保健(1.46,1.01-2.11)与 30 天再入院显著相关。从诊断到入院的时间间隔较长与再入院的可能性较低相关(0.95,0.91-1.00)。
COVID-19 患者出院后再入院和死亡率均较低。大多数再入院发生在早期,且主要与呼吸系统疾病相关,这可能反映了急性疾病病程延长。