Avcı Ali, Özer Muhammet Raşit, Küçükceran Kadir, Yurdakul Mehmet Serkan
Karaman Training and Research Hospital Emergency Department Karaman Turkey.
Karamanoğlu Mehmetbey University Emergency Department Faculty of Medicine, Karaman Turkey.
J Acute Med. 2022 Dec 1;12(4):131-138. doi: 10.6705/j.jacme.202212_12(4).0001.
Patient admissions beyond the capacity of emergency departments (EDs) have been reported since the coronavirus disease (COVID-19) pandemic. Thus, laboratory parameters to predict the readmission of patients discharged from the ED are needed. For this purpose, we investigated whether C-reactive protein (CRP) level and neutrophil-to-lymphocyte ratio (NLR) could predict the readmission of patients with COVID-19.
Patients aged >18 years who visited the ED in October 2020 and had positive polymerase chain reaction test results were evaluated. Among these patients, those who were not hospitalized and were discharged from the ED on the same day were included in the study. The patients' readmission status within 14 days after discharge, age, sex, complaint on admission, comorbidity, systolic blood pressure, diastolic blood pressure, fever, pulse, oxygen saturation level, CRP level, blood urea nitrogen level, creatinine level, neutrophil count, lymphocyte count, and NLR were recorded. Data were compared between the groups.
Of the 779 patients who were included in the study, 359 (46.1%) were male. The median age was 41 years (range, 31-53 years). Among these patients, those who were not hospitalized and were discharged from the ED on logistic regression analysis, age, CRP level, NLR, loss of smell and taste, and hypertension had odds ratios of 2.494, 2.207, 1.803, 0.341, and 1.879, respectively.
The strongest independent predictor of readmission within 14 days after same-day ED discharge was age > 50 years. In addition, CRP level and NLR were the laboratory parameters identified as independent predictors of ED readmission.
自冠状病毒病（COVID-19）大流行以来，急诊科（ED）收治超出其容量的患者的情况已有报道。因此，需要实验室指标来预测从急诊科出院患者的再入院情况。为此，我们研究了C反应蛋白（CRP）水平和中性粒细胞与淋巴细胞比值（NLR）是否能够预测COVID-19患者的再入院情况。
对2020年10月前往急诊科就诊且聚合酶链反应检测结果呈阳性的18岁以上患者进行评估。在这些患者中，未住院且于同日从急诊科出院的患者被纳入研究。记录患者出院后14天内的再入院状态、年龄、性别、入院主诉、合并症、收缩压、舒张压、发热、脉搏、血氧饱和度水平、CRP水平、血尿素氮水平、肌酐水平、中性粒细胞计数、淋巴细胞计数和NLR。对组间数据进行比较。
纳入研究的779例患者中，359例（46.1%）为男性。中位年龄为41岁（范围31 - 53岁）。在这些患者中，未住院且从急诊科出院的患者经逻辑回归分析显示，年龄、CRP水平,NLR、嗅觉和味觉丧失以及高血压的比值比分别为2.494、2.207、1.803、0.341和1.879。
同日急诊科出院后14天内再入院的最强独立预测因素是年龄>50岁。此外，CRP水平和NLR是被确定为急诊科再入院独立预测因素的实验室指标。
