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2020年美国因心肌炎住院的COVID-19患者30天再入院情况及相关危险因素分析。

Analysis of 30-day hospital readmissions and related risk factors for COVID-19 patients with myocarditis hospitalized in the United States during 2020.

作者信息

Patel Krishna, Majeed Harris, Gajjar Rohan, Cannon Harmon, Bobba Aniesh, Quazi Mohammad, Gangu Karthik, Sohail Amir Humza, Sheikh Abu Baker

机构信息

Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.

Department of Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, USA.

出版信息

Proc (Bayl Univ Med Cent). 2024 Mar 19;38(1):34-41. doi: 10.1080/08998280.2024.2325280. eCollection 2025.

Abstract

BACKGROUND

Despite extensive research on COVID-19 and its association with myocarditis, limited data are available on readmission rates for this subset of patients. Thirty-day hospital readmission rate is an established quality metric that is associated with increased mortality and cost.

METHODS

This retrospective analysis utilized the Nationwide Readmission Database for the year 2020 to evaluate 30-day hospital readmission rates, risk factors, and clinical outcomes among COVID-19 patients who presented with myocarditis at their index hospitalization.

RESULTS

Our analysis revealed that 1) the 30-day all-cause hospital readmission rate for patients initially hospitalized with COVID-19 and myocarditis was 11.7%; 2) after multivariate adjustment, the primary predictor of readmission for COVID-19 patients with myocarditis was discharge against medical advice; 3) COVID-19 patients with myocarditis who required readmission had a higher proportion of older patients and Medicare beneficiaries; 4) the most common diagnoses at readmission were COVID-19, sepsis, congestive heart failure, acute myocardial infarction, and pneumonia; and 5) readmitted patients were more likely to require renal replacement therapy during their index hospitalization.

CONCLUSION

This study underscores the importance of optimizing discharge plans, preventing irregular discharges through shared decision-making, and ensuring robust post-hospital follow-up for patients with COVID-19 and myocarditis at index admission.

摘要

背景

尽管对新冠病毒疾病(COVID-19)及其与心肌炎的关联进行了广泛研究,但关于这类患者再入院率的数据仍然有限。30天医院再入院率是一项既定的质量指标,与死亡率和成本增加相关。

方法

这项回顾性分析利用了2020年全国再入院数据库,以评估首次住院时出现心肌炎的COVID-19患者的30天医院再入院率、风险因素和临床结局。

结果

我们的分析显示,1)最初因COVID-19和心肌炎住院的患者30天全因医院再入院率为11.7%;2)经过多变量调整后,心肌炎COVID-19患者再入院的主要预测因素是违反医嘱出院;3)需要再入院的心肌炎COVID-19患者中,老年患者和医疗保险受益人的比例更高;4)再入院时最常见的诊断是COVID-19、败血症、充血性心力衰竭、急性心肌梗死和肺炎;5)再入院患者在首次住院期间更有可能需要肾脏替代治疗。

结论

本研究强调了优化出院计划、通过共同决策防止不规范出院以及确保对首次入院时患有COVID-19和心肌炎的患者进行有力的出院后随访的重要性。

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