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. 2021 Oct 1;92(S6):e2021419.
doi: 10.23750/abm.v92iS6.12244.

COVID-19 second wave: appropriateness of admissions to the Emergency Department of a main metropolitan hospital in Milan

Eleonora Bossi  1 , Vincenza Gianfredi  2 , Anna Odone  3 , Davide Valsecchi  4 , Stefano Franchini  5 , Massimiliano Etteri  6 , Guglielmo Cornero  7 , Giuseppina Maria Casiraghi  8 , Nicolò Maimeri  9 , Paolo Federico Beccaria  10 , Elena Moizo  11 , Milena Mucci  12 , Paolo Silvani  13 , Valentina Paola Plumari  14 , Giovanni Borghi  15 , Nicola Pasculli  16 , Alessia La Bruna  17 , Martina Baiardo Redaelli  18 , Antonio Dell'Acqua  19 , Maria Luisa Azzolini  20 , Francesca Guzzo  21 , Ada Carla Alba  22 , Stella Sordoni  23 , Margherita Tozzi  24 , Francesco Giuseppe Nisi  25 , Stefano Fresilli  26 , Alberto Zangrillo  27 , Carlo Signorelli  28
Affiliations

COVID-19 second wave: appropriateness of admissions to the Emergency Department of a main metropolitan hospital in Milan

Eleonora Bossi et al. Acta Biomed. .

Abstract

Background: In Europe, Italy and Lombardy, in autumn 2020, there was a steep increase in reported cases due to the second epidemic wave of SARS-Cov-2 infection. We aimed to evaluate the appropriateness of COVID-19 patients' admissions to the ED of the San Raffaele Hospital.

Methods: We compared data between the inter-wave period (IWP, from 1st to 30th September) and the second wave period (WP, 1st October to 15th November) focusing on the ED presentation, discharge priority colour code and outcomes.

Results: Out of 977 admissions with a SARS-Cov-2 positive swab, 6% were in the IWP and 94% in the WP. Red, yellow and white code increased (these latter from 1.8% to 5.4%) as well as self-presented in yellow and white code. Discharges home increased from 1.8% to 5.4%, while hospitalizations decreased from 63% to 51%.

Discussion: We found a rise in white codes (among self-presented patients), indicating inappropriateness of admissions. The increase in discharges suggests that several patients did not require hospitalization.

Conclusions: The pandemic brought out the fundamental role of primary care to manage patients with low-intensity needs. The important increase in ED admissions of COVID-19 patients caused a reduction of NO-COVID-19 patients, with possible inadequate treatment.

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Conflict of interest statement

The authors declare that there is no conflict of interest and this research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Figures

Figure 1.
Figure 1.
Barplot of discharge priority colour code’s distribution from 1st to 30thSeptember 2020 (IWP) and from 1st October to 15th November 2020 (WP). Legend. red code indicates a very critical, yellow medium critical, green low critical, white non-critical status
Figure 2.
Figure 2.
Barplot of outcomes’ distribution from 1st to 30thSeptember 2020 (IWP) and from 1st October to 15th November 2020 (WP).
See this image and copyright information in PMC

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