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

Yıl 2022, , 609 - 615, 10.12.2022
https://doi.org/10.26453/otjhs.1140897

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. 

Kaynakça

  • 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
  • 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.
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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

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

Yıl 2022, , 609 - 615, 10.12.2022
https://doi.org/10.26453/otjhs.1140897

Öz

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. 

Kaynakça

  • 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
  • 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.
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Hatice Esen 0000-0003-1164-9086

Tuğba Çalışkan 0000-0003-0844-9200

Adeviyye Karaca 0000-0002-5338-1826

Yayımlanma Tarihi 10 Aralık 2022
Gönderilme Tarihi 5 Temmuz 2022
Kabul Tarihi 21 Eylül 2022
Yayımlandığı Sayı Yıl 2022

Kaynak Göster

AMA Esen H, Çalışkan T, Karaca A. Readmission to the Emergency Room and Clinical Characteristics of Patients with Covid-19: A Single-Center Trial. OTSBD. Aralık 2022;7(4):609-615. doi:10.26453/otjhs.1140897

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