Javier Jacob1, Arantxa Albert-Casado1, Juan G Del-Castillo2, Pere Llorens-Soriano3, Sonia Jiménez-Hernández4, Guillermo Burillo-Putze5, Alfonso Martín-Martínez6, Francisco J Martín-Sánchez2, Eric J García-Lamberechts2, Pascual Piñera-Salmerón7, Aitor Alquézar-Arbé8, Carles Ferre-Losa1, María Á Juan-Gómez9, Leticia Serrano-Lázaro10, José Noceda-Bermejo11, Manuel Salido-Mota12, María J Fortuny-Bayarri13, Matilde González-Tejera14, José M Ferreras-Amez15, Elena Díaz-Fernández16, Eva Quero-Motto17, Ana Peiró-Gómez18, Enrique Martín-Mojarro19, Ferran Llopis-Roca1, Arturo Huerta-García20, Jorge Pedraza-García21, Napoleón Meléndez-Cálix22, José V Brazó-Aznar23, María J Cano-Cano24, Óscar Miró25. 1. Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. 2. Emergency Department, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain. 3. Emergency Department, Hospital General de Alicante, University Miguel Hernández, Elche, Alicante, Spain. 4. Emergency Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain. 5. Emergency Department, Hospital Universitario de Canarias, Tenerife, Spain. 6. Emergency Department, Hospital Universitario de Móstoles, Madrid, Spain. 7. Emergency Department, Hospital Reina Sofía, Murcia, Spain. 8. Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 9. Emergency Department, Hospital Universitario Doctor Peset, Valencia, Spain. 10. Emergency Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain. 11. Emergency Department, Hospital Clínico Universitario de Valencia, Valencia, Spain. 12. Emergency Department, Hospital Universitario Regional de Málaga, Málaga, Spain. 13. Emergency Department, Hospital Francesc de Borja de Gandia, Valencia, Spain. 14. Emergency Department, Hospital General Universitario de Elche, Alicante, Spain. 15. Emergency Department, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain. 16. Emergency Department, Hospital Universitario Sant Joan, Alicante, Spain. 17. Emergency Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain. 18. Emergency Department, Hospital de Llíria, Valencia, Spain. 19. Emergency Department, Hospital de Sant Pau i Santa Tecla, Tarragona, Spain. 20. Emergency Department, Clinica Sagrada Familia, Barcelona, Spain. 21. Emergency Department, Hospital Valle de los Pedroche de Pozoblanco, Córdoba, Spain. 22. Emergency Department, Hospital Virgen de los Lírios, Alcoy, Alicante, Spain. 23. Emergency Department, Hospital Universitario de la Ribera, Valencia, Spain. 24. Emergency Department, Hospital Arnau de Vilanova, Valencia, Spain. 25. Emergency Department, Hospital Clínic de Barcelona, Spain.
Abstract
BACKGROUND: Information is needed on the safety and efficacy of direct discharge from the emergency department (ED) of patients with COVID-19 pneumonia. OBJECTIVES: The objectives of the study were to study the variables associated with discharge from the ED in patients presenting with COVID-19 pneumonia, and study ED revisits related to COVID-19 at 30 days (EDR30d). METHODS: Multicenter study of the SIESTA cohort including 1198 randomly selected COVID patients in 61 EDs of Spanish medical centers from March 1, 2020, to April 30, 2020. We collected baseline and related characteristics of the acute episode and calculated the adjusted odds ratios (aOR) for ED discharge. In addition, we analyzed the variables related to EDR30d in discharged patients. RESULTS: We analyzed 859 patients presenting with COVID-19 pneumonia, 84 (9.8%) of whom weredischarged from the ED. The variables independently associated with discharge were being a woman (aOR 1.890; 95%CI 1.176 3.037), age < 60 years (aOR 2.324; 95%CI 1.353-3.990), and lymphocyte count > 1200/mm3 (aOR 4.667; 95%CI 1.045-20.839). The EDR30d of the ED discharged group was 40.0%, being lower in women (aOR 0.368; 95%CI 0.142-0.953). A totalof 130 hospitalized patients died (16.8%) as did two in the group discharged from the ED (2.4%) (OR 0.121; 95%CI 0.029-0.498). CONCLUSION: Discharge from the ED in patients with COVID-19 pneumonia was infrequent and was associated with few variables of the episode. The EDR30d was high, albeit with a low mortality.
BACKGROUND: Information is needed on the safety and efficacy of direct discharge from the emergency department (ED) of patients with COVID-19 pneumonia. OBJECTIVES: The objectives of the study were to study the variables associated with discharge from the ED in patients presenting with COVID-19 pneumonia, and study ED revisits related to COVID-19 at 30 days (EDR30d). METHODS: Multicenter study of the SIESTA cohort including 1198 randomly selected COVID patients in 61 EDs of Spanish medical centers from March 1, 2020, to April 30, 2020. We collected baseline and related characteristics of the acute episode and calculated the adjusted odds ratios (aOR) for ED discharge. In addition, we analyzed the variables related to EDR30d in discharged patients. RESULTS: We analyzed 859 patients presenting with COVID-19 pneumonia, 84 (9.8%) of whom weredischarged from the ED. The variables independently associated with discharge were being a woman (aOR 1.890; 95%CI 1.176 3.037), age < 60 years (aOR 2.324; 95%CI 1.353-3.990), and lymphocyte count > 1200/mm3 (aOR 4.667; 95%CI 1.045-20.839). The EDR30d of the ED discharged group was 40.0%, being lower in women (aOR 0.368; 95%CI 0.142-0.953). A totalof 130 hospitalized patients died (16.8%) as did two in the group discharged from the ED (2.4%) (OR 0.121; 95%CI 0.029-0.498). CONCLUSION: Discharge from the ED in patients with COVID-19 pneumonia was infrequent and was associated with few variables of the episode. The EDR30d was high, albeit with a low mortality.
Authors: Arantxa Albert; Pere Llorens; Alfons Aguirre; Francisco Javier Martín-Sánchez; Silvia Mínguez; Oscar Moreno; Carles Ferré; Adrián Valls; Begoña Espinosa; Oscar Murillo; Isabel Cirera; Adriana Gil; Samuel Rivera; Ferran Llopis; Pierre Malchair; Juan Gonzalez Del Castillo; Javier Jacob Journal: J Healthc Qual Res Date: 2022-06-08