Relevance of prediction scores derived from the SARS-CoV-2 first wave, in the evolving UK COVID-19 second wave, for safe early discharge and mortality: a PREDICT COVID-19 UK prospective observational cohort study

Ghani, Hakim; Navarra, Alessio; Pyae, Phyoe Kyaw; Mitchell, Harry; Evans, William K.; Cama, Rigers; Shaw, Michael; Critchlow, Ben; Vaghela, Tejal; Schechter, Miriam; Nordin, Nazril; Barlow, Andrew; Vancheeswaran, Rama

doi:10.1136/bmjopen-2021-054469

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…28,29 During the COVID-19 pandemic, this strategy was successfully implemented to create surge capacity in overwhelmed hospitals. 30,31 Limitations Firstly, the data search did not cover gray literature, hence anecdotal experiences and reports might have been missed. Secondly, all but one study is based on simulated events and results could be different once more evidence from real events is collected.…”

Section: Discussionmentioning

confidence: 99%

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Primary Health Care and Disasters: Applying a “Whole-of-Health System” Approach through Reverse Triage in Mass-Casualty Management

Alesi,

Bortolin,

Ragazzoni

et al. 2023

Prehosp. Disaster med.

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Introduction: In 2019, the World Health Organization (WHO) published the Health Emergency and Disaster Risk Management (H-EDRM) framework detailing how effective management of disasters, including mass-casualty incidents (MCIs), can be achieved through a whole-of-health system approach where each level of the health care system is involved in all phases of the disaster cycle. In light of this, a primary health care (PHC) approach can contribute to reducing negative health outcomes of disasters, since it encompasses the critical roles that primary care services can play during crises. Hospitals can divert non-severe MCI victims to primary care services by applying reverse triage (RT), thereby preventing hospital overloading and ensuring continuity of care for those who do not require hospital services during the incident. Study Objective: This study explores the topic by reviewing the literature published on early discharge of MCI victims through RT criteria and existing referral pathways to primary care services. Methods: A scoping literature review was performed and a total of ten studies were analyzed. Results: The results showed that integrating primary care facilities into disaster management (DM) through the use of RT may be an effective strategy to create surge during MCIs, provided that clear referral protocols exist between hospitals and primary care services to ensure continuity of care. Furthermore, adequate training should be provided to primary care professionals to be prepared and be able to provide quality care to MCI victims. Conclusion: The results of this current review can serve as groundwork upon which to design further research studies or to help devise strategies and policies for the integration of PHC in MCI management.

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Section: Discussionmentioning

confidence: 99%

“… 28 , 29 During the COVID-19 pandemic, this strategy was successfully implemented to create surge capacity in overwhelmed hospitals. 30 , 31 …”

Section: Discussionmentioning

confidence: 99%

Primary Health Care and Disasters: Applying a “Whole-of-Health System” Approach through Reverse Triage in Mass-Casualty Management

Alesi,

Bortolin,

Ragazzoni

et al. 2023

Prehosp. Disaster med.

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Analysis of Clinical Criteria for Discharge Among Patients Hospitalized for COVID-19: Development and Validation of a Risk Prediction Model

Schnipper,

Oreper,

Hubbard

et al. 2024

J GEN INTERN MED

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Background Patients hospitalized with COVID-19 can clinically deteriorate after a period of initial stability, making optimal timing of discharge a clinical and operational challenge. Objective To determine risks for post-discharge readmission and death among patients hospitalized with COVID-19. Design Multicenter retrospective observational cohort study, 2020–2021, with 30-day follow-up. Participants Adults admitted for care of COVID-19 respiratory disease between March 2, 2020, and February 11, 2021, to one of 180 US hospitals affiliated with the HCA Healthcare system. Main Measures Readmission to or death at an HCA hospital within 30 days of discharge was assessed. The area under the receiver operating characteristic curve (AUC) was calculated using an internal validation set (33% of the HCA cohort), and external validation was performed using similar data from six academic centers associated with a hospital medicine research network (HOMERuN). Key Results The final HCA cohort included 62,195 patients (mean age 61.9 years, 51.9% male), of whom 4704 (7.6%) were readmitted or died within 30 days of discharge. Independent risk factors for death or readmission included fever within 72 h of discharge; tachypnea, tachycardia, or lack of improvement in oxygen requirement in the last 24 h; lymphopenia or thrombocytopenia at the time of discharge; being ≤ 7 days since first positive test for SARS-CoV-2; HOSPITAL readmission risk score ≥ 5; and several comorbidities. Inpatient treatment with remdesivir or anticoagulation were associated with lower odds. The model’s AUC for the internal validation set was 0.73 (95% CI 0.71–0.74) and 0.66 (95% CI 0.64 to 0.67) for the external validation set. Conclusions This large retrospective study identified several factors associated with post-discharge readmission or death in models which performed with good discrimination. Patients 7 or fewer days since test positivity and who demonstrate potentially reversible risk factors may benefit from delaying discharge until those risk factors resolve.

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Performance of the 4C and SEIMC scoring systems in predicting mortality from onset to current COVID-19 pandemic in emergency departments

de Santos Castro,

del Pozo Vegas,

Pinilla Arribas

et al. 2024

Sci Rep

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Relevance of prediction scores derived from the SARS-CoV-2 first wave, in the evolving UK COVID-19 second wave, for safe early discharge and mortality: a PREDICT COVID-19 UK prospective observational cohort study

Cited by 3 publications

References 27 publications

Primary Health Care and Disasters: Applying a “Whole-of-Health System” Approach through Reverse Triage in Mass-Casualty Management

Primary Health Care and Disasters: Applying a “Whole-of-Health System” Approach through Reverse Triage in Mass-Casualty Management

Analysis of Clinical Criteria for Discharge Among Patients Hospitalized for COVID-19: Development and Validation of a Risk Prediction Model

Performance of the 4C and SEIMC scoring systems in predicting mortality from onset to current COVID-19 pandemic in emergency departments

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