专门的团队为需要吸氧的 COVID-19 门诊患者提供护理：住院再入院率低。
Dedicated team to ambulatory care for patients with COVID-19 requiring oxygen: Low rate of hospital readmission.
机构信息
Infectiologie, Centre Hospitalier Universitaire de Guadeloupe, Les Abymes, Guadeloupe, France.
Service d'Accueil des Urgences, Centre Hospitalier Universitaire de Guadeloupe, Les Abymes, Guadeloupe, France.
出版信息
Int J Infect Dis. 2022 Oct;123:92-96. doi: 10.1016/j.ijid.2022.07.057. Epub 2022 Aug 17.
OBJECTIVES
We aimed to determine the impact of a dedicated medical team (DMT) on ambulatory care for patients requiring oxygen.
METHODS
The DMT selected patients requiring oxygen for less than 5 l/min in the emergency department (ED). The rate of ED readmission was compared in patients managed by the DMT and those managed by the ED physicians (EDPs). Consensual treatment for COVID-19 pneumonia with oxygen requirement was steroids + preventive anticoagulation.
RESULTS
A total of 1397 patients with COVID-19 came to our ED from the first to the 31 of August, 2021, among whom 580 (41%) had ambulatory care. A total of 82 (14.1%) patients were managed by the DMT, with a rate of ED readmission of 4.8% (4/82), compared with 13.6% (68/498) for those managed by EDPs (P <0.001). Focusing on the 45/498 (9.0%) patients requiring oxygen and managed by EDPs, the rate of ED readmission was 20%, P = 0.017. Prescription of the consensual treatment concerned 96% versus 40% for those patients requiring oxygen for the DMT and the EDP, respectively (P <0.001).
CONCLUSION
A DMT for ambulatory care of patients with COVID-19 requiring oxygen was associated with less return to the ED than usual practices.
目的
我们旨在确定专门医疗团队（DMT）对需要氧气的门诊患者护理的影响。
方法
DMT 选择在急诊科（ED）需要低于 5 l/min 氧气的患者。比较由 DMT 管理的患者和由 ED 医生（EDP）管理的患者的 ED 再入院率。COVID-19 肺炎伴有氧气需求的共识治疗是类固醇+预防性抗凝。
结果
2021 年 8 月 1 日至 31 日期间，共有 1397 例 COVID-19 患者来到我们的 ED，其中 580 例（41%）需要门诊治疗。共有 82 例（14.1%）患者由 DMT 管理，ED 再入院率为 4.8%（4/82），而 EDP 管理的患者为 13.6%（68/498）（P<0.001）。在需要氧气并由 EDP 管理的 45/498 例（9.0%）患者中，ED 再入院率为 20%，P=0.017。需要氧气的患者，DMT 组的共识治疗处方率为 96%，而 EDP 组为 40%（P<0.001）。
结论
对于需要氧气的 COVID-19 门诊患者，DMT 管理与常规实践相比，ED 再入院率较低。
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