Risk factors associated with hospital admission in COVID-19 patients initially admitted to an observation unit
| Autor: | Alex Croft, Frances M. Russell, Robert R. Ehrman, Jake Jacobs, Alfred Z. Wang, Caleb Larsen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Observation unit Radiography Logistic regression Article 03 medical and health sciences Young Adult 0302 clinical medicine Patient Admission Clinical Observation Units Risk Factors Internal medicine medicine Humans Pandemics Risk stratification Aged Retrospective Studies Aged 80 and over Inpatients business.industry SARS-CoV-2 COVID-19 030208 emergency & critical care medicine Emergency department General Medicine Hypoxia (medical) Middle Aged Adverse outcomes Confidence interval United States Hospitalization Hospital admission Emergency Medicine Female medicine.symptom business Emergency Service Hospital Follow-Up Studies |
| Zdroj: | The American Journal of Emergency Medicine |
| ISSN: | 1532-8171 0735-6757 |
| Popis: | Background No set guidelines to guide disposition decisions from the emergency department (ED) in patients with COVID-19 exist. Our goal was to determine characteristics that identify patients at high risk for adverse outcomes who may need admission to the hospital instead of an observation unit. Methods We retrospectively enrolled 116 adult patients with COVID-19 admitted to an ED observation unit. We included patients with bilateral infiltrates on chest imaging, COVID-19 testing performed, and/or COVID-19 suspected as the primary diagnosis. The primary outcome was hospital admission. We assessed risk factors associated with this outcome using univariate and multivariable logistic regression. Results Of 116 patients, 33 or 28% (95% confidence interval [CI] 20–37%) required admission from the observation unit. On multivariable logistic regression analysis, we found that hypoxia defined as room-air oxygen saturation 48 years, bilateral infiltrates, hypoxia, and Hispanic race, bilateral infiltrates, hypoxia yield an OR for admission of 4.99 (CI 1.50–16.65) with an AUC of 0.59 (CI 0.51–0.67) and 6.78 (CI 2.11–21.85) with an AUC of 0.62 (CI 0.54–0.71), respectively. Conclusions Over 1/4 of suspected COVID-19 patients admitted to an ED observation unit ultimately required admission to the hospital. Risk factors associated with admission include hypoxia, bilateral infiltrates on chest radiography, or the combination of these two factors plus either age > 48 years or Hispanic race. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect