Risk of readmission to the emergency department in mild COVID-19 outpatients with telehealth follow-up
Fil: Pedretti Ana. Hospital Italiano de Buenos Aires; Argentina.
| Main Authors: | , , , , , , , , |
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| Format: | publishedVersion |
| Language: | eng |
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2021
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| Online Access: | http://hdl.handle.net/11086/20291 https://revistas.unc.edu.ar/index.php/med/article/view/32414 |
| _version_ | 1801215828699381760 |
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| author | Pedretti, Ana Marquez Fosser, Santiago Pasquinelli, Rosario Vallone, Marcelo Plazzotta, Fernando Luna, Daniel Martínez, Bernardo Rodríguez, Paz Grande Ratti, María Florencia |
| author_facet | Pedretti, Ana Marquez Fosser, Santiago Pasquinelli, Rosario Vallone, Marcelo Plazzotta, Fernando Luna, Daniel Martínez, Bernardo Rodríguez, Paz Grande Ratti, María Florencia |
| author_sort | Pedretti, Ana |
| collection | Repositorio Digital Universitario |
| description | Fil: Pedretti Ana. Hospital Italiano de Buenos Aires; Argentina. |
| format | publishedVersion |
| id | rdu-unc.20291 |
| institution | Universidad Nacional de Cordoba |
| language | eng |
| publishDate | 2021 |
| record_format | dspace |
| spelling | rdu-unc.202912021-09-14T05:04:15Z Risk of readmission to the emergency department in mild COVID-19 outpatients with telehealth follow-up Riesgo de reconsulta al servicio de urgencias en pacientes COVID-19 leves con seguimiento ambulatorio mediante telemedicina Risco de readmissão ao departamento de emergência em pacientes ambulatoriais com COVID-19 leve com acompanhamento de telessaúde Pedretti, Ana Marquez Fosser, Santiago Pasquinelli, Rosario Vallone, Marcelo Plazzotta, Fernando Luna, Daniel Martínez, Bernardo Rodríguez, Paz Grande Ratti, María Florencia Covid 19 SARS-CoV-2 Emergency medical services Coronavirus infections Ambulatory care Telemedicine Patient readmission Servicios médicos de urgencia Infecciones por coronavirus Atención ambulatoria Telemedicina Readmisión del paciente Serviços médicos de emergencia Infecções por coronavirus Assistência ambulatorial Readmissão do pacient publishedVersion Fil: Pedretti Ana. Hospital Italiano de Buenos Aires; Argentina. Fil: Marquez Fosser, Santiago. Hospital Italiano de Buenos Aires; Argentina. Fil: Pasquinelli, Rosario. Hospital Italiano de Buenos Aires; Argentina. Fil: Vallone, Marcelo. Hospital Italiano de Buenos Aires; Argentina. Fil: Plazzotta, Fernando. Hospital Italiano de Buenos Aires; Argentina. Fil: Luna, Daniel. Hospital Italiano de Buenos Aires; Argentina. Fil: Martínez, Bernardo. Hospital Italiano de Buenos Aires; Argentina. Fil: Rodríguez, Paz. Hospital Italiano de Buenos Aires; Argentina. Fil: Grande Ratti, María Florencia. Hospital Italiano de Buenos Aires. Área de Investigación en Medicina Interna; Argentina. Introduction: To describe patients ́ characteristics of confirmed COVID-19 with mild symptoms discharged home from the Emergency Department (ED) and followed using telemedicine, to estimate ED-readmission rates and hospitalization, and to explore associated factors with these clinical outcomes. Methods: We performed a retrospective cohort study in Hospital Italiano de Buenos Aires from June to August 2020, which included patients with mild COVID-19 symptoms, diagnosed with a positive result. Follow-up occurred from discharged until ED-readmission or 14 days. We estimate cumulative incidence using the Kaplan-Meier model and associated factors using logistic regression. Results: We included 1,239 patients, with a median of 41 years and 53.82% male. A total of 167 patients were readmitted to the ED within 14 days, with a global incidence rate of 13.08% (95%CI 11.32-15.08). Of these, 83 required hospitalization (median time from diagnosis 4.98 days), 5.98% was not related to any COVID-19 complication, and five patients died. After adjustment by confounders (age ≥65, sex, diabetes, hypertension, former smoking, active smoking, fever, diarrhea, and oxygen saturation), we found significant associations: former smoking (adjusted OR 2.09, 95% CI 1.31-3.34, p0 .002), fever (aOR 1.56,95% CI 1.07-2.28, p0.002) and oxygen saturation (aOR 0.82, 95% CI 0.71-0.95, p0.009).Conclusion: The 13% rate of ED-readmission during 14 days of follow-up of mild symptomatic COVID-19 patients initially managed as outpatients with telehealth is highly significant in hospital management, quality performance, and patient safety. Introducción: Describir las características de los pacientes COVID-19 con síntomas leves dados de alta desde la Central de Emergencias de Adultos (CEA) y seguidos en forma ambulatoria mediante telemedicina. Estimar las tasas de re-consulta a CEA y hospitalización, y explorar los factores asociados a estos desenlaces. Métodos: Cohorte retrospectiva de Junio a Agosto 2020 en el Hospital Italiano de Buenos Aires, que incluyó personas COVID-19 con síntomas leves. Se siguieron durante 14 días hasta la ocurrencia de re-consulta en CEA y/o hospitalización. Se utilizaron modelos de Kaplan-Meier y regresión logística. Resultados: De un total de 1.239 pacientes, con una mediana de 41 años y 53,82% varones, 167 pacientes re-consultaron a CEA, con una tasa de incidencia global a los14 días del 13,08% (IC del 95% 11,32 a 15,08). De estos, 83 requirieron hospitalización (media de 4,98 días), el 6% no se relaciona con COVID-19 y 5 pacientes fallecieron. Después del ajuste por factores confundidores (edad ≥65, sexo, diabetes, hipertensión, ex tabaquismo, tabaquismo activo, fiebre, diarrea y saturación de oxígeno), encontramos asociaciones significativas: tabaquismo anterior (ORa 2,09, IC95% 1,31-3,34, p0=0,002), fiebre (ORa 1,56, IC95% 1,07-2,28, p=0,002) y saturación de oxígeno (ORa 0,82, IC95% 0,71-0,95, p=0,009). Conclusión: La tasa del 13% de re-consulta a CEA durante 14 días de seguimiento resultó muy significativa para la gestión hospitalaria, la calidad del desempeño y la seguridad del paciente. Introdução: Descrever as características dos pacientes com COVID-19 com sintomas leves e altado Centro de Emergência de Adultos (CEA) e acompanhados ambulatorialmente por telemedicina. Estime as taxas de nova consulta ao CEA e de hospitalização e explore os fatores associados a esses resultados. Métodos: Coorte retrospectiva de junho a agosto de 2020 no Hospital Italiano de Buenos Aires, que incluiu COVID-19 com sintomas leves. Eles foram acompanhados por 14 dias até a ocorrência de nova consulta no CEA e / ou internação. Modelos de Kaplan-Meier e regressão logística foram usados. Resultados: De um total de 1.239 pacientes, com mediana de 41 anos e 53,82% homens, 167 pacientes consultaram novamente o CEA, com uma taxa de incidência global em 14 dias de 13,08% (IC95% 11,32 a 15,08). Destes, 83 necessitaram de hospitalização (média de 4,98 dias), 6% não estavam relacionados com COVID-19 e 5 pacientes morreram. Após o ajuste para fatores de confusão (idade ≥65, sexo, diabetes, hipertensão, ex-tabagismo, tabagismo ativo, febre, diarreia e saturação de oxigênio), encontramos associações significativas: tabagismo prévio (ORa 2,09, IC 95% 1,31-3,34, p0 = 0,002), febre (ORa 1,56, IC 95% 1,07-2,28, p = 0,002) e saturação de oxigênio (ORa 0,82, IC 95% 0,71-0,95, p = 0,009). Conclusão: A taxa de 13% de re-consulta ao CEA durante 14 dias de seguimento foi muito significativa para a gestão hospitalar, qualidade do desempenho e segurança do paciente. publishedVersion Fil: Pedretti Ana. Hospital Italiano de Buenos Aires; Argentina. Fil: Marquez Fosser, Santiago. Hospital Italiano de Buenos Aires; Argentina. Fil: Pasquinelli, Rosario. Hospital Italiano de Buenos Aires; Argentina. Fil: Vallone, Marcelo. Hospital Italiano de Buenos Aires; Argentina. Fil: Plazzotta, Fernando. Hospital Italiano de Buenos Aires; Argentina. Fil: Luna, Daniel. Hospital Italiano de Buenos Aires; Argentina. Fil: Martínez, Bernardo. Hospital Italiano de Buenos Aires; Argentina. Fil: Rodríguez, Paz. Hospital Italiano de Buenos Aires; Argentina. Fil: Grande Ratti, María Florencia. Hospital Italiano de Buenos Aires. Área de Investigación en Medicina Interna; Argentina. 2021-09-13T19:21:53Z 2021-09-13T19:21:53Z 2021-08-23 article Pedretti A, Marquez Fosser S, Pasquinelli R, Vallone M, Plazzotta F, Luna D, Martinez B, Rodriguez P, Grande Ratti MF. Riesgo de reconsulta al servicio de urgencias en pacientes COVID-19 leves con seguimiento ambulatorio mediante telemedicina. Rev Fac Cien Med Univ Nac Cordoba [Internet]. 23 de agosto de 2021 [citado 13 de septiembre de 2021];78(3):249-56. Disponible en: https://revistas.unc.edu.ar/index.php/med/article/view/32414 1853-0605 http://hdl.handle.net/11086/20291 https://revistas.unc.edu.ar/index.php/med/article/view/32414 eng Attribution-NonCommercial-NoDerivatives 4.0 Internacional http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| spellingShingle | Covid 19 SARS-CoV-2 Emergency medical services Coronavirus infections Ambulatory care Telemedicine Patient readmission Servicios médicos de urgencia Infecciones por coronavirus Atención ambulatoria Telemedicina Readmisión del paciente Serviços médicos de emergencia Infecções por coronavirus Assistência ambulatorial Readmissão do pacient Pedretti, Ana Marquez Fosser, Santiago Pasquinelli, Rosario Vallone, Marcelo Plazzotta, Fernando Luna, Daniel Martínez, Bernardo Rodríguez, Paz Grande Ratti, María Florencia Risk of readmission to the emergency department in mild COVID-19 outpatients with telehealth follow-up |
| title | Risk of readmission to the emergency department in mild COVID-19 outpatients with telehealth follow-up |
| title_full | Risk of readmission to the emergency department in mild COVID-19 outpatients with telehealth follow-up |
| title_fullStr | Risk of readmission to the emergency department in mild COVID-19 outpatients with telehealth follow-up |
| title_full_unstemmed | Risk of readmission to the emergency department in mild COVID-19 outpatients with telehealth follow-up |
| title_short | Risk of readmission to the emergency department in mild COVID-19 outpatients with telehealth follow-up |
| title_sort | risk of readmission to the emergency department in mild covid 19 outpatients with telehealth follow up |
| topic | Covid 19 SARS-CoV-2 Emergency medical services Coronavirus infections Ambulatory care Telemedicine Patient readmission Servicios médicos de urgencia Infecciones por coronavirus Atención ambulatoria Telemedicina Readmisión del paciente Serviços médicos de emergencia Infecções por coronavirus Assistência ambulatorial Readmissão do pacient |
| url | http://hdl.handle.net/11086/20291 https://revistas.unc.edu.ar/index.php/med/article/view/32414 |
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