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

• Javier Jacob Rodríguez ^[1] ; Arantxa Albert Casado ^[1] ; Juan Maria Gonzalez del Castillo ^[2] ; Pere Llorens Soriano ^[17] ; Guillermo Burillo Putze ^[3] ; Sonia Jiménez Hernández ^[4] ; Alfonso Martín Martínez ^[5] ; Francisco Javier Martín Sánchez ^[2] ; Eric J. García-Lamberechts ^[2] ; Pascual Piñera Salmerón ^[6] ; Aitor Alquezar ^[7] ; Carles Ferre Losa ^[18] ; María Ángeles Juan Gómez ^[8] ; Leticia Serrano ^[19] ; José J. Noceda Bermejo ^[9] ; Manuel Salido Mota ^[10] ; Maria José Fortuny Bayarre ^[20] ; Matilde González Tejera ^[11] ; José Manuel Ferreras Amez ^[12] ; María Elena Díaz Fernández ^[21] ; Eva Quero Motto ^[22] ; Ana Peiró Gómez ^[23] ; Enrique Martín Mojarro ^[13] ; Ferran Llopis Roca ^[1] ; Arturo Huerta ^[24] ; Jorge Pedraza García ^[25] ; Napoleón Meléndez Cálix ^[14] ; José V. Brazó Aznar ^[26] ; María J. Cano Cano ^[15] ; Óscar Miró Andreu ^[16]
  1. [1] Hospital Universitari de Bellvitge

     Hospital Universitari de Bellvitge

     l'Hospitalet de Llobregat, España

     
  2. [2] Hospital Clínico San Carlos de Madrid

     Hospital Clínico San Carlos de Madrid

     Madrid, España

     
  3. [3] Hospital Universitario de Canarias

     Hospital Universitario de Canarias

     San Cristóbal de La Laguna, España

     
  4. [4] Universitat de Barcelona

     Universitat de Barcelona

     Barcelona, España

     
  5. [5] Hospital de Móstoles

     Hospital de Móstoles

     Móstoles, España

     
  6. [6] Hospital Reina Sofía

     Hospital Reina Sofía

     Tudela, España

     
  7. [7] Hospital de la Santa Creu i Sant Pau

     Hospital de la Santa Creu i Sant Pau

     Barcelona, España

     
  8. [8] Hospital Universitario Doctor Peset

     Hospital Universitario Doctor Peset

     Valencia, España

     
  9. [9] Hospital Clinico Universitario de Valencia

     Hospital Clinico Universitario de Valencia

     Valencia, España

     
  10. [10] Hospital Regional Universitario de Málaga

      Hospital Regional Universitario de Málaga

      Málaga, España

      
  11. [11] Hospital General Universitario de Elche

      Hospital General Universitario de Elche

      Elche, España

      
  12. [12] Hospital Clínico Universitario Lozano Blesa

      Hospital Clínico Universitario Lozano Blesa

      Zaragoza, España

      
  13. [13] Hospital de Sant Pau i Santa Tecla

      Hospital de Sant Pau i Santa Tecla

      Tarragona, España

      
  14. [14] Hospital Virgen de los Lirios

      Hospital Virgen de los Lirios

      Alcoy, España

      
  15. [15] Hospital Arnau de Vilanova

      Hospital Arnau de Vilanova

      Valencia, España

      
  16. [16] Hospital Clinic Barcelona

      Hospital Clinic Barcelona

      Barcelona, España

      
  17. [17] Hospital General de Alicante, University Miguel Hernández, Elche, Alicante
  18. [18] Emergency Department, 1Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona
  19. [19] Hospital Universitario y Politécnico La Fe, Valencia
  20. [20] Hospital Francesc de Borja de Gandia, Valencia;
  21. [21] Hospital Universitario Sant Joan, Alicante
  22. [22] Hospital Universitario Virgen de la Arrixaca, Murcia
  23. [23] Hospital de Llíria, Valencia
  24. [24] Clinica Sagrada Familia, Barcelona
  25. [25] Hospital Valle de los Pedroche de Pozoblanco, Córdoba
  26. [26] Hospital Universitario de la Ribera, Valencia

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• Localización: Revista de investigación clínica, ISSN 0034-8376, ISSN-e 2564-8896, Vol. 74, Nº. 3, 2022, págs. 135-146
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • 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 were discharged 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 total of 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.