Covid-19 Hastalarının Acil Servise Tekrar Başvuru Oranı ve Klinik Özellikleri: Tek Merkezli Çalışma

Öz

Amaç: Bu araştırmada, COVID-19 tanısıyla 72 saat içerisinde bir eğitim ve araştırma hastanesi acil servisine tekrar başvuran hastaların demografik ve klinik özelliklerini belirlemek amaçlanmıştır.

Materyal ve Metot: Araştırma tanımlayıcı ve tek merkezli planlandı. COVID-19 tanısıyla acil servise başvuran hastaların verileri geriye dönük olarak Hastane Bilgi Yönetim Sisteminden elde edildi.

Bulgular: Acil servise COVID-19 tanısıyla toplam 56.497 hasta başvurmuş ve bu hastalardan %0,4’ü 72 saat içinde benzer şikayetlerle acil servise tekrar başvuru yapmıştır. Tekrar başvuru yapan hastaların %51,4’ü kadın ve yaş ortalaması 41,67 olduğu tespit edildi. Tekrar başvuran kişilerin %30,8’inde en az bir komorbidite olduğu saptandı, komorbiditesi olan hastalarda en sık başvuru nedeni bulantı ve öksürük idi.

Sonuç: COVID-19 hastalarının güvenli bir şekilde eve gönderilme kriterlerinin oluşturulması ve tekrar başvuru oranlarının düşürülüp bakım kalitesinin artırılması için ileri çalışmaların tasarımına ihtiyaç vardır. 

Anahtar Kelimeler

• Acil servis
• COVID-19
• tekrar başvuru

Readmission to the Emergency Room and Clinical Characteristics of Patients with Covid-19: A Single-Center Trial

Abstract

Objective: This study aims to determine the demographic and clinical characteristics of patients admitted to the emergency department of a training and research hospital within 72 hours of the diagnosis of COVID-19.

Materials and Methods: The study was designed as descriptive and single-centered. The data of patients who presented to the emergency room with the diagnosis of COVID-19 were obtained retrospectively from the Hospital Information Management System.

Results: 56.497 patients diagnosed with COVID-19 presented to our emergency room, and 0.4% returned to the emergency room with similar complaints within 72 hours. Among those who returned, 51.4% were female, and the mean age was 41.67. This study found that 30.8% of readmitted people had at least one comorbidity. It was found that 30.8% of the readmission had at least one comorbidity; nausea and cough were the most common reasons for admission in patients with comorbidities.

Conclusion: There is a need to design further studies to establish the criteria for the safe return of COVID-19 patients to home, to reduce the re-admission rates, and increase the quality of care. 

Keywords

• COVID-19
• Acil servis
• readmission

References

1. Payza U, Karakaya Z, Topal FE. An unsolvable public health problem; improper use of emergency services and patients’ views. Celal Bayar University-Health Sciences Institute Journal. 2020;7(3):251-256. doi:10.34087/cbusbed.590562
2. Ministry of Health General Directorate of Turkish Public Hospitals. Public hospitals statistics report 2018. khgmistatistikdb.saglik.gov.tr/TR-43898/kamu-hastaneleri-istatistik-raporu.2017.html. Accessed January 10, 2021.
3. Rennert-may E, Leal J, Thanh NX, et al. The impact of COVID-19 on hospital admissions and emergency department visits : A population-based study. PLoS One. 2021;16(6):e0252441. doi:10.1371/journal.pone.0252441
4. Friebel R, Hauck K, Aylin P, Steventon A. National trends in emergency readmission rates: A longitudinal analysis of administrative data for England between 2006 and 2016. BMJ Open. 2018;8(3): e020325. doi:10.1136/bmjopen-2017-020325
5. Aslaner MA. Revisits of older patients to the emergency department within 72 hours. Acta Medica Alanya. 2019;3(3):267-271. doi:10.30565/medalanya.562963
6. Pham JC, Kirsch TD, Hill PM, DeRuggerio K, Hoffmann B. Seventy-two-hour returns may not be a good department : A national study. Acad Emerg Med. 2011;18(4):390-397. doi:10.1111/j.1553-2712.2011.01042.x
7. McCusker J, Cardin S, Bellavance F, Belzille E. Return to the emergency department among elders: Patterns and predictors. Acad Emerg Med. 2000;7(3):249-259. doi:10.1111/j.1553-2712.2000.tb01070.x
8. Blunt I, Bardsley M, Grove A, Clarke A. Classifying emergency 30-day readmissions in England using routine hospital data 2004 -2010 : What is the scope for reduction ? Emerg Med. 2015;32:44-50. doi:10.1136/emermed-2013-202531

9. Kilaru AS, Lee K, Snider CK, et al. Return hospital admissions among 1419 COVID-19 patients discharged from five US emergency departments. Acad Emerg Med. 2020;27(10):1039-1042. doi:10.1111/acem.14117
10. Friedmann PD, Jin LEI, Karrison TG, et al. Early revisit, hospitalization, or death among older persons discharged from the ED. Am J Emerg Med. 2001;19(2):125-129. doi:10.1053/ajem.2001.21321
11. Van Walraven C, Jennings A, Forster AJ. A meta-analysis of hospital 30-day avoidable readmission rates. J Eval Clin Pr. 2011;18(6):1211-1218. doi:10.1111/j.1365-2753.2011.01773.x
12. Kristensen SR, Bech M, Quentin W. A roadmap for comparing readmission policies with application to Denmark, England, Germany and the United States. Health Policy. 2015;119(3):264-273. doi:10.1016/j.healthpol.2014.12.009
13. Jeon WH, Seon JY, Park SY, Oh IW. Analysis of risk factors on readmission cases of COVID-19 in the Republic of Korea: Using nationwide health claims data. Int J Environ Res Public Health. 2020;17(16):5844-5855. doi:10.3390/ijerph17165844
14. Ye S, Hiura G, Fleck E, et al. Hospital readmissions after implementation of a discharge care program for patients with COVID-19 illness. J Gen Intern Med. 2021;36(3):722-729. doi:10.1007/s11606-020-06340-w
15. Wang X, Zhou Y, Jiang N, Zhou Q, Ma WL, Persistence of intestinal SARS-CoV-2 infection in patients with COVID-19 leads to re-admission after pneumonia resolved. Int J Infect Dis. 2020;95:433-435. doi.org/10.1016/j.ijid.2020.04.063
16. Durmus E, Guneysu F. Evaluation of re-hospitalized COVID-19 patients in a hospital. Rev Assoc Med Bras. 2020;66(12):1690-1695.doi:10.1590/1806-9282.66.12.1690
17. Somani SS, Richter F, Fuster V, et al. Characterization of patients who return to hospital following discharge from hospitalization for COVID-19. J Gen Intern Med. 2020;35(10):2838-2844. doi:10.1007/s11606-020-06120-6
18. Parra LM, Cantero M, Morrás I, et al. Hospital readmissions of discharged patients with COVID-19. Int J Gen Med. 2020;13:1359-1366. doi:10.2147/IJGM.S275775
19. Margus C, Sondheim SE, Peck NM, et al. Discharge in pandemic: Suspected COVID-19 patients returning to the emergency department within 72 hours for admission. Am J Emerg Med. 2020;45:185-191. doi:10.1016/j.ajem.2020.08.034
20. Uyaroglu OA, Basaran NÇ, Özisik L, et al. Thirty-day readmission rate of COVID-19 patients discharged from a tertiary care university hospital in Türkiye: An observational, single-center study. Int J Qual Heal Care. 2020;33(1):mzaa144. doi:10.1093/intqhc/mzaa144
21. Chen J, Xu X, Hu J, et al. Clinical course and risk factors for recurrence of positive SARS-CoV-2 RNA : A retrospective cohort study from Wuhan, China. Aging (Albany, NY). 2020;12(17):16675-16689. doi:10.18632/aging.103795
22. Wu R, Wang L, Kuo HC, et al. An update on current therapeutic drugs treating COVID-19. Curr Pharmacol Reports. 2021;6(3):56-70. doi:10.1007/s40495-020-00216-7