Servei d'Urgències Hospital Universitari de Bellvitge, Barcelona, España.
Emergencias. 2022 Feb;34(1):38-46.
To analyze the frequencies of 3 types of hospital revisits by patients after treatment for COVID-19 in the emergency department.
Retrospective observational study of consecutive patients who came to the emergency department in March and April 2020 and were discharged alive with a diagnosis of COVID-19. Baseline and acute episode data were collected and the patients were followed for 1 year. We analyzed variables associated with revisits for any reason, revisits related to COVID-19, and early COVID-19-related revisits (within 30 days).
A total of 1352 patients with a mean age of 62.1 years (52.9% male) were studied. A total of 553 revisits were made by 342 patients (25.3%) for any reason; 132 (9.8%) revisited in relation to COVID-19 at least once. Of those, 103 (7.6%) revisited within 30 days (early) and 29 (2.2%) came later. COVID-19-related revisits were associated with thrombotic events (odds ratio [OR], 7.58; 95% CI, 1.75-32.81) and pulmonary fibrosis (OR, 4.95; 95% CI, 1.27-19.24); early revisits were inversely associated with follow-up management by a contracted health care support service (OR, 0.18; 95% CI, 0.03-0.92). Hospital admission during the initial visit was significantly associated with fewer revisits for any reason or related to COVID-19 at any time.
Fewer than half the total number of emergency department revisits after initial care for COVID-19 were related to the novel coronavirus infection. Revisits occurred more often in the first 30 days after discharge. Later COVID-19-related revisits were uncommon, but given the large number of patients with this infection, such visits can be expected.
分析 COVID-19 患者在急诊科治疗后 3 种类型的医院复诊频率。
这是一项回顾性观察研究,连续纳入 2020 年 3 月和 4 月来急诊科且因 COVID-19 出院存活的患者。收集基线和急性期数据,并对患者进行为期 1 年的随访。我们分析了与任何原因、与 COVID-19 相关以及早期 COVID-19 相关(30 天内)复诊相关的变量。
共纳入 1352 例患者,平均年龄 62.1 岁(52.9%为男性)。共有 342 例患者(25.3%)因任何原因复诊 553 次;至少 1 次因 COVID-19 复诊 132 次(9.8%)。其中,103 次(7.6%)在 30 天内(早期)复诊,29 次(2.2%)复诊较晚。COVID-19 相关复诊与血栓事件(比值比[OR],7.58;95%置信区间,1.75-32.81)和肺纤维化(OR,4.95;95%置信区间,1.27-19.24)相关;早期复诊与签约医疗保健支持服务的随访管理呈负相关(OR,0.18;95%置信区间,0.03-0.92)。初次就诊时住院与任何原因或任何时间 COVID-19 相关的复诊次数较少显著相关。
初次 COVID-19 治疗后,急诊科复诊中仅有不到一半与新型冠状病毒感染有关。出院后 30 天内复诊更为常见。较晚的 COVID-19 相关复诊并不常见,但鉴于感染患者数量众多,预计会出现此类就诊。