Università Vita Salute San Raffaele, IRCCS Ospedale San Raffaele.
Università degli studi di Pavia, IRCCS Ospedale San Raffaele.
Acta Biomed. 2021 Oct 1;92(S6):e2021419. doi: 10.23750/abm.v92iS6.12244.
In Europe, Italy and Lombardy, in autumn 2020, there was a steep increase in reported cases due to the second epidemic wave of SARS-Cov-2 infection. We aimed to evaluate the appropriateness of COVID-19 patients' admissions to the ED of the San Raffaele Hospital.
We compared data between the inter-wave period (IWP, from 1st to 30th September) and the second wave period (WP, 1st October to 15th November) focusing on the ED presentation, discharge priority colour code and outcomes.
Out of 977 admissions with a SARS-Cov-2 positive swab, 6% were in the IWP and 94% in the WP. Red, yellow and white code increased (these latter from 1.8% to 5.4%) as well as self-presented in yellow and white code. Discharges home increased from 1.8% to 5.4%, while hospitalizations decreased from 63% to 51%.
We found a rise in white codes (among self-presented patients), indicating inappropriateness of admissions. The increase in discharges suggests that several patients did not require hospitalization.
The pandemic brought out the fundamental role of primary care to manage patients with low-intensity needs. The important increase in ED admissions of COVID-19 patients caused a reduction of NO-COVID-19 patients, with possible inadequate treatment.
2020 年秋季，在欧洲的意大利和伦巴第地区，由于 SARS-CoV-2 感染的第二波疫情，报告的病例数量急剧增加。我们旨在评估 COVID-19 患者到圣拉斐尔医院急诊部就诊的适宜性。
我们比较了两次波峰之间的间隔期（IWP，9 月 1 日至 30 日）和第二波期间（WP，10 月 1 日至 11 月 15 日）的数据，重点关注急诊部就诊、出院优先级颜色代码和结局。
在 977 例 SARS-CoV-2 阳性拭子检测结果阳性的患者中，6%的患者在 IWP 期间，94%的患者在 WP 期间。红色、黄色和白色代码的患者比例增加（从 1.8%增加到 5.4%），同时黄色和白色代码的自行就诊患者也增加了。从 1.8%增加到 5.4%，而住院治疗的比例从 63%下降到 51%。
我们发现白色代码（包括自行就诊患者）的增加表明入院的适宜性存在问题。出院人数的增加表明许多患者不需要住院治疗。
大流行凸显了初级保健在管理低强度需求患者方面的基本作用。COVID-19 患者急诊部就诊人数的大幅增加导致了非 COVID-19 患者的减少，可能导致对非 COVID-19 患者的治疗不足。
