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因 SARS-CoV-2 感染住院后早期再入院的发生率和危险因素:一项回顾性队列研究的结果。

Incidence and risk factors for early readmission after hospitalization for SARS-CoV-2 infection: results from a retrospective cohort study.

机构信息

Infectious Diseases Department, University Hospital Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, Spain.

Programa de Salut Internacional de Catalunya del Institut Català de la Salut (PROSICS), Barcelona, Spain.

出版信息

Infection. 2022 Apr;50(2):371-380. doi: 10.1007/s15010-021-01662-1. Epub 2021 Jul 30.

Abstract

PURPOSE

We aim to assess risk factors related to early readmission in previous hospitalized patients with COVID-19.

METHODS

We analyzed a retrospective cohort of patients with laboratory-confirmed COVID-19 admitted to Vall d'Hebron University Hospital, Barcelona, Spain. Early readmission was defined as the need for hospitalization within a period of 60 days after discharge. A descriptive analysis of the readmission was performed, including hospitalization outcome. We also performed a multivariate logistic regression to define risk factors for readmission RESULTS: A total of 629 patients were followed up during 60 days with a readmission cumulative incidence of 5.4% (34 out of 629) and an incidence rate of 0.034 person-years. Main reasons for readmission were respiratory worsening (13, 38.2%), decompensation of previous disease (12, 35.3%) or infectious complications (6, 17.6%). Median time to readmission was 12 days (interquartile range 7-33 days). Prior diagnosis of heart failure (OR 4.09; 95% CI 1.35-12.46; p = 0.013), length of stay during index admission greater than 13 days (OR 2.72; 95% CI 1.21-6.12; p = 0.015), treatment with corticosteroids (OR 2.39; 95% CI 1.01-5.70; p = 0.049) and developing pulmonary thromboembolism (OR 11.59; 95% CI 2.89-46.48; p = 0.001) were the risk factors statistically associated with early readmission.

CONCLUSION

Readmission cumulative incidence was 5.4%. Those patients with prior diagnosis of heart failure, length of stay greater than 13 days, treated with corticosteroids or who developed pulmonary thromboembolism might benefit from close monitoring after being discharged.

摘要

目的

我们旨在评估与 COVID-19 既往住院患者早期再入院相关的危险因素。

方法

我们分析了西班牙巴塞罗那 Vall d'Hebron 大学医院确诊为 COVID-19 的住院患者的回顾性队列。早期再入院定义为出院后 60 天内需要住院治疗。对再入院进行描述性分析,包括住院结局。我们还进行了多变量逻辑回归,以确定再入院的危险因素。

结果

共有 629 例患者在 60 天内进行了随访,再入院累积发生率为 5.4%(34/629),发病率为 0.034 人年。再入院的主要原因是呼吸恶化(13 例,38.2%)、原有疾病失代偿(12 例,35.3%)或感染性并发症(6 例,17.6%)。再入院的中位时间为 12 天(四分位间距 7-33 天)。既往心力衰竭诊断(OR 4.09;95%CI 1.35-12.46;p=0.013)、指数住院期间住院时间大于 13 天(OR 2.72;95%CI 1.21-6.12;p=0.015)、皮质类固醇治疗(OR 2.39;95%CI 1.01-5.70;p=0.049)和发生肺血栓栓塞症(OR 11.59;95%CI 2.89-46.48;p=0.001)是与早期再入院相关的统计学危险因素。

结论

再入院累积发生率为 5.4%。那些有既往心力衰竭诊断、住院时间大于 13 天、接受皮质类固醇治疗或发生肺血栓栓塞症的患者在出院后可能需要密切监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9548/8323963/795b7127c528/15010_2021_1662_Fig1_HTML.jpg

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