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Jacob J, Albert-Casado A, Del-Castillo JG, Llorens-Soriano P, Jiménez-Hernández S, Burillo-Putze G, Martín-Martínez A, Martín-Sánchez FJ, García-Lamberechts EJ, Piñera-Salmerón P, Alquézar-Arbé A, Ferre-Losa C, Juan-Gómez MÁ, Serrano-Lázaro L, Noceda-Bermejo J, Salido-Mota M, Fortuny-Bayarri MJ, González-Tejera M, Ferreras-Amez JM, Díaz-Fernández E, Quero-Motto E, Peiró-Gómez A, Martín-Mojarro E, Llopis-Roca F, Huerta-García A, Pedraza-García J, Meléndez-Cálix N, Brazó-Aznar JV, Cano-Cano MJ, Miró Ó. Safety and Revisit Related to Discharge the Sixty-one Spanish Emergency Department Medical Centers Without Hospitalization in Patients with COVID-19 Pneumonia. A Prospective Cohort Study UMC-Pneumonia COVID-19. Rev Invest Clin 2022; 74:135-146. [PMID: 35240755 DOI: 10.24875/ric.22000021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/08/2022] [Indexed: 06/14/2023]
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.
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Affiliation(s)
- Javier Jacob
- Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Arantxa Albert-Casado
- Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Juan G Del-Castillo
- Emergency Department, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain
| | - Pere Llorens-Soriano
- Emergency Department, Hospital General de Alicante, University Miguel Hernández, Elche, Alicante, Spain
| | | | | | | | | | | | | | - Aitor Alquézar-Arbé
- Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Carles Ferre-Losa
- Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - María Á Juan-Gómez
- Emergency Department, Hospital Universitario Doctor Peset, Valencia, Spain
| | | | - José Noceda-Bermejo
- Emergency Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Manuel Salido-Mota
- Emergency Department, Hospital Universitario Regional de Málaga, Málaga, Spain
| | | | | | - José M Ferreras-Amez
- Emergency Department, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
| | | | - Eva Quero-Motto
- Emergency Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | | | - Ferran Llopis-Roca
- Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Jorge Pedraza-García
- Emergency Department, Hospital Valle de los Pedroche de Pozoblanco, Córdoba, Spain
| | | | - José V Brazó-Aznar
- Emergency Department, Hospital Universitario de la Ribera, Valencia, Spain
| | | | - Óscar Miró
- Emergency Department, Hospital Clínic de Barcelona, Spain
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