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. 2022 Aug;94(8):3750-3756.
doi: 10.1002/jmv.27792. Epub 2022 May 4.

Longer length of stay, days between discharge/first readmission, and pulmonary involvement ≥50% increase prevalence of admissions in ICU in unplanned readmissions after COVID-19 hospitalizations

Sarah G Peixoto  1 , Jonas M Wolf  2 , Andressa B Glaeser  2 , Juçara G Maccari  3 , Luiz A Nasi  4
Affiliations

Longer length of stay, days between discharge/first readmission, and pulmonary involvement ≥50% increase prevalence of admissions in ICU in unplanned readmissions after COVID-19 hospitalizations

Sarah G Peixoto et al. J Med Virol. 2022 Aug.

Abstract

Hospital readmissions due to COVID-19 are one of the main concerns for the health system due to risks to the patient's life and increased use of health resources. Studies focusing on this issue are important to understand the risk factors and create strategies to avoid readmissions. We evaluated the readmission of patients with confirmed COVID-19 in a private hospital in southern Brazil, between March 2020 and 2021. Also, the characteristics and clinical outcomes of patients admitted to the intensive care unit (ICU) and nonadmitted were compared. Poisson regression models with prevalence ratio (PR) with 95% confidence intervals (95% CIs) were applied to confirm the association between variables and ICU admission. Of the 2084 hospitalized patients with COVID-19, 1806 were discharged alive. Among them, 106 were readmitted for unplanned reasons during one year. Early hospital readmission (≤30 days) occurred in 52.8% of the cases. The main reasons were respiratory, gastroenterological, kidney, and cardiac disease. The median age was 73.0 years old and women correspond to 52.8%. The presence of at least one comorbidity was detected in 87.7% of patients. Hypertension, diabetes, cardiac, and lung disease were more frequent. The ICU admitted patients (n = 43; 40.5%) mostly had 4-5 comorbidities, pulmonary involvement ≥50%, length of stay (LOS), and days between discharge and first readmission. Longer LOS (PR: 3.46; 95% CI: 1.24-5.67), days between discharge/first readmission (PR: 2.21; 95% CI: 1.15-5.88), and pulmonary involvement (≥50%; PR: 1.59; 95% CI: 1.11-3.54) were independently associated with ICU admission. Longer LOS, longer days between discharge/first readmission, and pulmonary involvement (≥50%) were associated with ICU admission in readmitted patients. Readmissions evaluation is pivotal and may help in ensuring safe care transition and postdischarge follow-up.

Keywords: comorbidities; coronavirus; healthcare system; hospital readmission; oxygen therapy.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart showing the selection criteria of the patients readmitted by COVID‐19.
Figure 2
Figure 2
Radar chart with percentual of causes of unplanned readmissions of COVID‐19 between March 2020 and 2021.
Figure 3
Figure 3
Length of stay in patients who were not readmitted and readmitted for unplanned causes.
Figure 4
Figure 4
Length of stay in patients with pulmonary involvement (<50%) and (≥50%).
See this image and copyright information in PMC

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