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Multicenter Study
. 2022 May 2;74(3):135-146.
doi: 10.24875/RIC.22000021.

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  1 , Arantxa Albert-Casado  1 , Juan G Del-Castillo  2 , Pere Llorens-Soriano  3 , Sonia Jiménez-Hernández  4 , Guillermo Burillo-Putze  5 , Alfonso Martín-Martínez  6 , Francisco J Martín-Sánchez  2 , Eric J García-Lamberechts  2 , Pascual Piñera-Salmerón  7 , Aitor Alquézar-Arbé  8 , Carles Ferre-Losa  1 , María Á Juan-Gómez  9 , Leticia Serrano-Lázaro  10 , José Noceda-Bermejo  11 , Manuel Salido-Mota  12 , María J Fortuny-Bayarri  13 , Matilde González-Tejera  14 , José M Ferreras-Amez  15 , Elena Díaz-Fernández  16 , Eva Quero-Motto  17 , Ana Peiró-Gómez  18 , Enrique Martín-Mojarro  19 , Ferran Llopis-Roca  1 , Arturo Huerta-García  20 , Jorge Pedraza-García  21 , Napoleón Meléndez-Cálix  22 , José V Brazó-Aznar  23 , María J Cano-Cano  24 , Óscar Miró  25
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Free article
Multicenter Study

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 et al. Rev Invest Clin. .
Free article

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.

Keywords: Discharge; Emergency department; Pneumonia COVID-19; Revisit.

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