Thirty-day readmission rate of COVID-19 patients discharged from a tertiary care university hospital in Turkey: an observational, single-center study

Abstract

Background The 30-day readmission rate is an important indicator of patient safety and hospital’s quality performance. In this study, we aimed to find out the 30-day readmission rate of mild and moderate severity COVID-19 patients discharged from a tertiary care university hospital and to demonstrate the possible factors associated with readmission. Methods This is an observational, single-center study. Epidemiological and clinical data of patients who were hospitalized with a diagnosis of COVID-19 were retrieved from a research database where patient information was recorded prospectively. Readmission data was sought from the hospital information management system and National Health Record System to detect if the patients were readmitted to any hospital within 30 days of discharge. Adult patients (≥18 years-old) hospitalized in COVID-19 wards with a diagnosis of mild or moderate COVID-19 between March 20, 2020 (when the first case was admitted to our hospital), and April 26, 2020 were included. Results From March 26 to May 1, there were 154 mild or moderate severity (non-critical) COVID-19 patients discharged from COVID-19 wards, of which 11 (7.1%) were readmitted The median time of readmission was 8.1 days (IQR=5.2). Two patients (18.1%) were categorized to have mild disease and the remaining 9 (81.9%) as moderate disease. Two patients who were over 65 years of age and had metastatic cancers and hypertension developed sepsis and died in the hospital during the readmission episode. Malignancy (18.7% vs 2.1%, P = 0.04) and hypertension (45.5% vs 14%, P = 0.02) were more common in those who were readmitted. Conclusions This is one of the first studies to report on 30-day readmission rate of COVID-19 in the literature. More comprehensive studies are needed to reveal the causes and predictors of COVID-19 readmissions.

Sixty-day consequences of COVID-19 in patients discharged from hospital: an electronic health records study

“…Previous studies of outcomes following COVID-19 have focused mainly on survival during hospitalization, and the few studies that have linked discharged patient to longer-term outcomes have been too small to assess differences by demographic factors 3 , 4 ; neither have such studies tended to consider the importance of death as a competing risk when analyzing readmissions post-discharge. 7–9 A recent study in Michigan State (USA) found a high rate of major adverse events following admission for COVID-19, with one-fifth (22%) of patients readmitted or dead within 60 days, 10 but risk factors for such outcomes were not assessed.…”

“…In particular, there is limited information on risk factors for adverse outcomes following discharge, such as readmission or death; previous studies have tended to be too small to assess variation by patient characteristics. 3 , 4 This study describes the variation in the risk of readmission or death within 60 days of discharge following hospitalization for COVID-19, by age, sex and ethnicity.…”

Risk Factors for Readmission in the Patients with COVID-19 Admitted to Hospital

“…In the follow-up of 279 discharged patients in Rhode Island of the United States, 30 days after discharge, readmission rate was reported 6.7% (11). In a study done in Turkish study, 7.1% of discharged patients were readmitted (15). The readmission rate of 106,543 COVID-19 patients discharged from the hospital two months after discharge was 9% in the United States (9).…”

“…Mostly male gender, old age and the presence of underlying disease or history of malignancy are associated with poor prognosis and readmission in this group of patients (11,12,15). Paying too much attention to COVID-19 pandemic has caused deception to pay attention to other serious diseases such as neoplasms or cardiovascular diseases, which leads to increased mortality in populations and based on the experience of previous respiratory pandemics, the effective use of hospital beds should be an essential goal in the pandemic (4,(16)(17)(18).…”

Emergency department visits and readmissions after COVID-19 hospitalization: a cross-sectional analysis

“…Our 30-day hospital readmission rate of 11% is higher than most reported comparisons both in the US (2.2% overall readmission rate in New York City [ 6 ], 6.8% 30-day hospital readmission in Rhode Island [ 7 ], 10.3% overall hospital readmission in Boston [ 8 ]) and globally (2.3% overall hospital readmission in Wuhan [ 9 ], 4.4% overall hospital readmission in Madrid [ 10 ], 4.5% overall hospital readmission in South Korea [ 11 ], 7.1% 30-day hospital readmission in Turkey [ 12 ]). This could reflect the fact that some studies defined readmissions more strictly as COVID-related presentation or that some were confounded by a large number of patients remaining hospitalized during the study time period.…”