Characteristics of patients discharged and readmitted after COVID-19 hospitalisation within a large integrated health system in the United States

Huang, Cheng-Wei; Desai, Prashant P.; Wei, Kenneth; Liu, In‐Lu Amy; Lee, Janet; Nguyen, Huong Q.

doi:10.1080/23744235.2021.1924398

Cited by 13 publications

(14 citation statements)

References 13 publications

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“…This finding was aligned with previous multicentric studies that reported readmission rates from 4.5 to 7%. 20 , 21 , 22 Our study highlighted that older individuals and those admitted with severe COVID-19 disease remain at risk of complications after discharge. The higher mortality and rehospitalization rates in the elderly could be due to a lower avidity in mounting a humoral response in those individuals.…”

Section: Discussionmentioning

confidence: 75%

In-hospital mortality and severe outcomes after hospital discharge due to COVID-19: A prospective multicenter study from Brazil

Perazzo

Cardoso

Ribeiro

et al. 2022

The Lancet Regional Health - Americas

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Section: Discussionmentioning

confidence: 75%

In-hospital mortality and severe outcomes after hospital discharge due to COVID-19: A prospective multicenter study from Brazil

Perazzo

Cardoso

Ribeiro

et al. 2022

The Lancet Regional Health - Americas

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“…1 ). Eventually, 36 studies were included in the present systematic review and 28 were incorporated in the meta-analysis [ 7 , 9 , 11 , [13] , [14] , [15] , [16] , 19 , 20 , 23 , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] ]. Overall, 28 articles were included in phase 1 to determine risk factors and outcome of readmitted COVID-19 patients, and 19 articles were included in phase 2 to determine the cause of readmissions.…”

Section: Resultsmentioning

confidence: 99%

Characteristics, risk factors, and outcomes associated with readmission in COVID-19 patients: A systematic review and meta-analysis

Akbari

Fathabadi

Razmi

et al. 2022

The American Journal of Emergency Medicine

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Background We aimed to determine the characteristics, risk factors, and outcomes associated with readmission in COVID-19 patients. Methods PubMed, Embase, Web of Science, and Scopus databases were searched to retrieve articles on readmitted COVID-19 patients, available up to September 25, 2021. All studies comparing characteristics of readmitted and non-readmitted COVID-19 patients were included. We also included articles reporting the reasons for readmission in COVID-19 patients. Data were pooled and meta-analyzed using random or fixed-effect models, as appropriate. Subgroup analyses were conducted based on the place and duration of readmission. Results Our meta-analysis included 4823 readmitted and 63,413 non-readmitted COVID-19 patients. The re-hospitalization rate was calculated at 9.3% with 95% Confidence Interval (CI) [5.5%–15.4%], mostly associated with respiratory or cardiac complications (48% and 14%, respectively). Comorbidities including cerebrovascular disease (Odds Ratio (OR) = 1.812; 95% CI [1.547–2.121]), cardiovascular (2.173 [1.545–3.057]), hypertension (1.608 [1.319–1.960]), ischemic heart disease (1.998 [1.495–2.670]), heart failure (2.556 [1.980–3.300]), diabetes (1.588 [1.443–1.747]), cancer (1.817 [1.526–2.162]), kidney disease (2.083 [1.498–2.897]), chronic pulmonary disease (1.601 [1.438–1.783]), as well as older age (1.525 [1.175–1.978]), male sex (1.155 [1.041–1.282]), and white race (1.263 [1.044–1.528]) were significantly associated with higher readmission rates ( P < 0.05 for all instances). The mortality rate was significantly lower in readmitted patients (OR = 0.530 [0.329–0.855], P = 0.009). Conclusions Male sex, white race, comorbidities, and older age were associated with a higher risk of readmission among previously admitted COVID-19 patients. These factors can help clinicians and policy-makers predict, and conceivably reduce the risk of readmission in COVID-19 patients.

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“…3,4 Recent studies have reported relatively low rates of readmissions predominantly from respiratory complaints early in the post-discharge period. 3,[5][6][7] Studies have also identified increased age and comorbidities to be associated with readmissions. 3,4,7 Despite growing understanding of post-discharge outcomes and risk factors for readmissions following hospitalization, the optimal timing for discharging patients hospitalized with COVID-19 remains uncertain.…”

Section: Introductionmentioning

confidence: 99%

“…3,[5][6][7] Studies have also identified increased age and comorbidities to be associated with readmissions. 3,4,7 Despite growing understanding of post-discharge outcomes and risk factors for readmissions following hospitalization, the optimal timing for discharging patients hospitalized with COVID-19 remains uncertain. Many identified risk factors, such as age and comorbidities, are fixed and not actionable for healthcare providers.…”

Section: Introductionmentioning

confidence: 99%

Disease-Specific Factors Associated with Readmissions or Mortality After Hospital Discharge in COVID-19 Patients: a Retrospective Cohort Study

et al. 2022

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Background Understanding the implications of disease-specific factors beyond baseline patient characteristics for coronavirus disease 2019 (COVID-19) may allow for identification of indicators for safe hospital discharge. Objective Assess whether disease-specific factors are associated with adverse events post-discharge using a data-driven approach. Design Retrospective cohort study. Setting Fifteen medical centers within Kaiser Permanente Southern California. Participants Adult patients ( n =3508) discharged alive following hospitalization for COVID-19 between 05/01/2020 and 09/30/2020. Interventions None. Main Measures Adverse events defined as all-cause readmission or mortality within 14 days of discharge. Least absolute shrinkage and selection operator (LASSO) was used for variable selection and logistic regression was performed to estimate odds ratio (OR) and 95% confidence interval (CI). Key Results Four variables including age, Elixhauser index, treatment with remdesivir, and symptom duration at discharge were selected by LASSO. Treatment with remdesivir was inversely associated with adverse events (OR: 0.46 [95%CI: 0.36–0.61]), while symptom duration ≤ 10 days was associated with adverse events (OR: 2.27 [95%CI: 1.79–2.87]) in addition to age (OR: 1.02 [95%CI: 1.01–1.03]) and Elixhauser index (OR: 1.15 [95%CI: 1.11–1.20]). A significant interaction between remdesivir and symptom duration was further observed ( p =0.01). The association of remdesivir was stronger among those with symptom duration ≤10 days vs >10 days at discharge (OR: 0.30 [95%CI: 0.19–0.47] vs 0.62 [95%CI: 0.44–0.87]), while the association of symptom duration ≤ 10 days at discharge was weaker among those treated with remdesivir vs those not treated (OR: 1.31 [95%CI: 0.79–2.17] vs 2.71 [95%CI 2.05–3.59]). Conclusions Disease-specific factors including treatment with remdesivir, symptom duration, and their interplay may help guide clinical decision making at time of discharge. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-022-07610-5.

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Characteristics of patients discharged and readmitted after COVID-19 hospitalisation within a large integrated health system in the United States

Cited by 13 publications

References 13 publications

In-hospital mortality and severe outcomes after hospital discharge due to COVID-19: A prospective multicenter study from Brazil

In-hospital mortality and severe outcomes after hospital discharge due to COVID-19: A prospective multicenter study from Brazil

Characteristics, risk factors, and outcomes associated with readmission in COVID-19 patients: A systematic review and meta-analysis

Disease-Specific Factors Associated with Readmissions or Mortality After Hospital Discharge in COVID-19 Patients: a Retrospective Cohort Study

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