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Emergencias . Factors associated with revisits by patients with SARS-CoV-2 infection discharged from a hospital emergency department

tetano

Editor, Senior Moderator
Emergencias


. 2020 Nov;32(6):386-394.

Factors associated with revisits by patients with SARS-CoV-2 infection discharged from a hospital emergency department


[Article in Spanish, En]

Beatriz L?pez-Barbeito[SUP] 1 [/SUP], Ana Garc?a-Mart?nez[SUP] 1 [/SUP], Blanca Coll-Vinent[SUP] 1 [/SUP], Arrate Placer[SUP] 1 [/SUP], Carme Font[SUP] 1 [/SUP], Carmen Rosa Vargas[SUP] 1 [/SUP], Carolina S?nchez[SUP] 1 [/SUP], Daniela Pi?ango[SUP] 1 [/SUP], Elisenda G?mez-Angelats[SUP] 1 [/SUP], David Curtelin[SUP] 1 [/SUP], Emilio Salgado[SUP] 1 [/SUP], Francisco Aya[SUP] 1 [/SUP], Gemma Mart?nez-Nada[SUP] 1 [/SUP], Jos? Ram?n Alonso[SUP] 1 [/SUP], Julia Garc?a-Gozalbes[SUP] 1 [/SUP], Leticia Fresco[SUP] 1 [/SUP], Miguel Galicia[SUP] 1 [/SUP], Milagrosa Perea[SUP] 1 [/SUP], Miriam Carb?[SUP] 1 [/SUP], Nerea Iniesta[SUP] 1 [/SUP], Ona Escoda[SUP] 1 [/SUP], Rafael Perell?[SUP] 1 [/SUP], Sandra Cuerpo[SUP] 1 [/SUP], Vanesa Flores[SUP] 1 [/SUP], Xavier Alemany[SUP] 1 [/SUP], ?scar Mir?[SUP] 1 [/SUP], M? Del Mar Ortega[SUP] 1 [/SUP], Grupo de Trabajo sobre la atenci?n de la COVID-19 en Urgencias (COVID19-URG)



Affiliations
  • PMID: 33275358

Abstract

in English, Spanish
Objectives: To analyze emergency department (ED) revisits from patients discharged with possible coronavirus disease 2019 (COVID-19).
Material and methods: Retrospective observational study of consecutive patients who came to the ED over a period of 2 months and were diagnosed with possible COVID-19. We analyzed clinical and epidemiologic variables, treatments given in the ED, discharge destination, need to revisit, and reasons for revisits. Patients who did or did not revisit were compared, and factors associated with revisits were explored.
Results: The 2378 patients included had a mean age of 57 years; 49% were women. Of the 925 patients (39%) discharged, 170 (20.5%) revisited the ED, mainly for persistence or progression of symptoms. Sixty-six (38.8%) were hospitalized. Odds ratios (ORs) for the following factors showed an association with revisits: history of rheumatologic disease (OR, 2.97; 95% CI, 1.10-7.99; P = .03), digestive symptoms (OR, 1.73; 95% CI, 1.14-2.63; P = .01), respiratory rate over 20 breaths per minute (OR, 1.03; 95% CI, 1.0-1.06; P = .05), and corticosteroid therapy given in the ED (OR, 7.78; 95% CI, 1.77-14.21, P = .01). Factors associated with hospitalization after revisits were age over 48 years (OR, 2.57; 95% CI, 1 42-4.67; P = .002) and fever (OR, 4.73; 95% CI, 1.99-11.27; P = .001).
Conclusion: Patients under the age of 48 years without comorbidity and with normal vitals can be discharged from the ED without fear of complications. A history of rheumatologic disease, fever, digestive symptoms, and a respiratory rate over 20 breaths per minute, or a need for corticosteroid therapy were independently associated with revisits. Fever and age over 48 years were associated with a need for hospitalization.
 
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