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Multicenter Study
. 2021 Sep:47:239-243.
doi: 10.1016/j.ajem.2021.04.050. Epub 2021 Apr 19.

Emergency department bounceback characteristics for patients diagnosed with COVID-19

Adam Haag  1 , Sarah S Dhake  2 , Jessica Folk  2 , Urmila Ravichadran  3 , Andrea Maric  3 , Sarah Donlan  2 , Chad Konchak  3 , Loretta Au  3 , Nirav S Shah  2 , Ernest Wang  2
Affiliations
Multicenter Study

Emergency department bounceback characteristics for patients diagnosed with COVID-19

Adam Haag et al. Am J Emerg Med. 2021 Sep.

Abstract

Background: The global healthcare burden of COVID-19 continues to rise. There is currently limited information regarding the disease progression and the need for hospitalizations in patients who present to the Emergency Department (ED) with minimal or no symptoms.

Objectives: This study identifies bounceback rates and timeframes for patients who return to the ED due to COVID-19 after initial discharge on the date of testing.

Methods: Using the NorthShore University Health System's (NSUHS) Enterprise Data Warehouse (EDW), we conducted a retrospective cohort analysis of patients who were tested positive for COVID-19 and were discharged home on the date of testing. A one-month follow-up period was included to ensure the capture of disease progression.

Results: Of 1883 positive cases with initially mild symptoms, 14.6% returned to the ED for complaints related to COVID-19. 56.9% of the mildly symptomatic bounceback patients were discharged on the return visit while 39.5% were admitted to the floor and 3.6% to the ICU. Of the 1120 positive cases with no initial symptoms, only four returned to the ED (0.26%) and only one patient was admitted. Median initial testing occurred on day 3 (2-5.6) of illness, and median ED bounceback occurred on day 9 (6.3-12.7). Our statistical model was unable to identify risk factors for ED bouncebacks.

Conclusion: COVID-19 patients diagnosed with mild symptoms on initial presentation have a 14.6% rate of bounceback due to progression of illness.

Keywords: Bounceback rates; COVID-19; Coronavirus; Emergency department.

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Conflict of interest statement

Declaration of Competing Interest There were no conflicts of interest for any authors on this paper. No one, other than the stated authors, had control over the data analysis, interpretation, wording or conclusions described in the paper.

Figures

Fig. 1
Fig. 1
Flow diagram for study cohort.
See this image and copyright information in PMC

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