A study published in the Journal of General Internal Medicine by researchers at the Icahn School of Medicine at Mount Sinai describes characteristics of patients with COVID-19 who returned to the ER or required readmission to the hospital within 14 days of being discharged. Understanding what conditions impact these patient outcomes can help improve care during the hospital stay and after discharge.
Researchers found the most common cause for a patient's early hospital readmission after discharge was for respiratory distress. These patients were also more likely to have other ailments including chronic obstructive pulmonary disease and hypertension.
Of the nearly 2,900 discharged patients, more than 100 (3.6%) returned for emergency care after about 4.5 days; 56 of those returning patients required readmittance into the hospital. Half the patients returned for respiratory complications. Compared to patients who did not return, those returning had higher rates of chronic obstructive pulmonary disease and hypertension.
Patients who returned also had a shorter length hospital stay during treatment, lower rates of anticoagulation treatment, and were less likely to require intensive care. Age, sex, and race/ethnicity were no different among readmitted patients compared to those who did not return.
The findings provide insight that can potentially lead to improved care for patients hospitalized with COVID-19 to reduce both complications after discharge and hospital readmissions.
Researchers examined data collected from electronic health records including time spent in the emergency department and within an outpatient lab visit. They also considered more than 100 variables including demographics, key vitals, disease diagnoses, comorbid conditions, procedures during hospitalization, ICU-level care, and outcomes.
The researchers concluded that a return to the hospital after admission for COVID-19 within 14 days of discharge was relatively low for the majority of patients. However, the most common cause for a patient's return to the hospital was for respiratory distress. Patients who returned were more likely to have chronic obstructive pulmonary disease and hypertension.
Mount Sinai's Girish Nadkarni says, "This study shows that many patients have lingering effects from hospitalization for COVID-19 and thus, there is opportunity for longitudinal studies that could further assess the long-term effects of COVID on patient outcomes when they are discharged."
"COVID-19 has diminished and then resurged in many places, and as such, it is crucial for us to understand the post-hospitalization course and risk factors for coming back into the hospital," adds Mount Sinai's Dr. Anuradha Lala. "While caring for patients during the peak of the pandemic in NYC, our focus was on safe and efficient discharge to make room for new patients and prevent additional exposure. As we move into a phase where COVID-19 is no longer a novel disease, we must transition our attention to the post-acute phase to understand how to keep patients well and out of the hospital."
Authors of the paper were Girish Nadkarni, MD, Co-Chair; Anuradha Lala, MD, Member; Benjamin Glicksberg, PhD, Member; and other coauthors of the Mount Sinai COVID Informatics Center at the Icahn School of Medicine at Mount Sinai.
Source: Mount Sinai Health System