Roig-Sánchez Nuria, Talaya Peñalver Alberto, Poveda Ruiz Noemí, Del Pozo Alfonso, Hernández Campillo Ana María, Pérez Bernabéu Alicia, Martínez-López Belén, González-Cuello Inmaculada, García-López María, Borrajo Brunete Emilio, Wikman-Jorgensen Philip, Llenas-García Jara
Servicio de Medicina Interna; Hospital Vega Baja. San Bartolomé (Alicante). España.
Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO). Valencia. España.
Rev Esp Salud Publica. 2024 Mar 19;98:e202403023.
Readmission for COVID-19 is associated with high mortality, saturation of health services, and high costs. This study aimed to assess the incidence and risk factors of readmissions in COVID-19 patients in a regional hospital of Spain from February 2020 to March 2021.
A retrospective cohort study describing the characteristics of adult patients readmitted within thirty days of discharge after being infected with SARS-CoV-2 was carried out. Readmission associated risk factors were analysed using a binary logistic regression model.
Of the 967 patients who survived their first COVID-19 admission, 70 (7.2%) were readmitted within thirty days. Of these, 34.3% presented pneumonia progression, 15.7% functional deterioration, and 12.9% other infections. The mortality rate during readmission was 28.6%. There were no statistically significant differences in the cumulative incidence of readmissions between the epidemic periods (p=0.241). Factors independently associated with readmission were: diabetes mellitus (aOR 1.96, 95%CI 1.07-3.57, p=0.030); acute kidney failure (aOR 2.69, 95%CI 1.43-5.07, p=0.002); not being a candidate for intensive care (aOR 7.68, 95% CI 4.28-13.80, p<0.001); and not being prescribed corticosteroids at discharge (aOR 2.15, 95% CI 1.04-4.44; p=0.039).
A substantial proportion of patients admitted due to COVID-19 are readmitted, and they carry a high letality. Diabetes mellitus, acute kidney failure, not being a candidate for ICU admission, and not being prescribed corticosteroids on discharge are independently associated with an increased risk of readmission.
新型冠状病毒肺炎（COVID-19）再入院与高死亡率、医疗服务饱和及高成本相关。本研究旨在评估2020年2月至2021年3月西班牙一家地区医院中COVID-19患者再入院的发生率及危险因素。
开展一项回顾性队列研究，描述感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）后出院30天内再次入院的成年患者特征。使用二元逻辑回归模型分析再入院相关危险因素。
在首次因COVID-19入院存活的967例患者中，70例（7.2%）在30天内再次入院。其中，34.3%出现肺炎进展，15.7%功能恶化，12.9%发生其他感染。再入院期间死亡率为28.6%。不同流行时期再入院累积发生率无统计学显著差异（p = 0.241）。与再入院独立相关的因素有：糖尿病（调整后比值比[aOR]1.96，95%置信区间[CI]1.07 - 3.57，p = 0.030）；急性肾衰竭（aOR 2.69，95%CI 1.43 - 5.07，p = 0.002）；非重症监护候选人（aOR 7.68，95%CI 4.28 - 13.80，p < 0.001）；出院时未开具皮质类固醇药物（aOR 2.15，95%CI 1.04 - 4.44；p = 0.039）。
相当一部分因COVID-19入院的患者会再次入院，且死亡率很高。糖尿病、急性肾衰竭、非重症监护病房（ICU）入院候选人以及出院时未开具皮质类固醇药物与再入院风险增加独立相关。
