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Yoğun Bakım Ünitesinden Taburcu Edilen Koronavirüs Hastalığı-2019 Hastalarının Hastaneye Tekrar Başvurularının Değerlendirilmesi

Yıl 2022, Cilt: 6 Sayı: 1, 53 - 57, 28.04.2022
https://doi.org/10.29058/mjwbs.961476

Öz

Amaç: Koronavirus hastalığı-2019 (COVID-19) sonrası taburcu olan hastaların bir çok şikayetle hastanelere başvurduğu görülmüştür. Başvuru nedenlerini ve süresi hakkında bilgi sahibi olmak taburculuk sonrası bakımı yönlendirebilir. Bu çalışmada yoğun bakım ünitesinden taburcu olan COVID-19 hastalarında ilk 60 gün hastaneye yeniden başvuru oranını ve nedenlerini analiz etmeyi amaçladık.
Gereç ve Yöntem: Üçüncü basamak yoğun bakım ünitesinde Mart 2020-Şubat 2021 tarihleri arasında COVID-19 tanısı ile interne edilen olguların taburculuktan sonraki ilk 60 gün içinde aynı hastaneye yapılan başvuruları retrospektif olarak değerlendirildi. Taburculuk durumları, taburculuk sonrası ilk başvuru süresi, başvuru şikayetleri ve başvurulan birimler kaydedildi.
Bulgular: Toplam 145 hasta değerlendirildi. Bu hastaların 89’u (%61) exitus olurken 56’sı (%39) taburcu edilmiştir. Taburcu olan hastaların 38’i taburculuk sonrası hastaneye başvururken, 18’inin hastaneye başvurmadığı görüldü. Hastaneye ilk başvuru süreleri ortalama 21.34 gündü. En sık başvuru şikayetleri dispne ve kırgınlık-yorgunluktu. Yoğun bakımda takip edildikleri dönemde mekanik ventilatör ihtiyacı olan hastaların daha yüksek oranla hastaneye başvurdukları görüldü.
Sonuç: COVID-19 sonrası YBÜ’den taburcu olan hastaların ilk 60 gün hastaneye yeniden başvuru oranı yüksektir. Yeniden başvuru için prediktif faktörlerin belirlenerek taburculuk sonrası yakın takip ihtiyacı olan hastaların belirlenmesi önemlidir. Bunun için daha geniş çalışmalara ihtiyaç duyulmaktadır.

Kaynakça

  • 1) World Health Organization. Coronavirus Disease (COVID-19) Situation Reports. 2020. Available online: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports (accessed on 11 August 2020).
  • 2) Atalla E, Kalligeros M, Giampaolo G, Mylona EK, Shehadeh F, Mylonakis E. Readmissions among patients with COVID-19. Int J Clin Pract 2021 Mar;75(3):e13700.
  • 3) Somani SS, Richter F, Fuster V, De Freitas JK, Naik N, Sigel K, Nadkarni GN. Characterization of patients who return to hospital following discharge from hospitalization for COVID-19. J Gen Intern Med 2020 35(10), 2838-2844.
  • 4) Parra LM, Cantero M, Morrás I, Vallejo A, Diego I, Jiménez-Tejero E, Múñez E, Asensio Á, Fermández-Cruz A, Ramos-Martinez A; Puerta de Hierro Hospital Admission Study Group. Hospital Readmissions of Discharged Patients with COVID-19. Int J Gen Med 2020 Dec 2;13:1359-1366.
  • 5) Yeo I, Baek S, Kim J, Elshakh H, Voronina A, Lou MS, Vapnik J, Kaler R, Dai X, Goldbarg S. Assessment of thirty-day readmission rate, timing, causes and predictors after hospitalization with COVID-19. J Intern Med 2021 Jan Epub ahead of print.
  • 6) How to manage post-viral fatigue after COVID-19. Erişim: https://www.rcot.co.uk/how-manage-post-viral-fatigue-after-covid-19-0.
  • 7) Uyaroğlu OA, Başaran NÇ, Özişik L, Dİzman GT, Eroğlu İ, Şahİn TK, Taş Z, İnkaya AÇ, Tanriöver MD, Metan G, Güven GS, Ünal S. Thirty-day readmission rate of COVID-19 patients discharged from a tertiary care university hospital in Turkey: an observational, single-center study. Int J Qual Health Care. 2021 Feb 20;33(1):mzaa144.
  • 8) Eroğlu İ, Eroğlu BÇ, Güven GS. Altered tryptophan absorption and metabolism could underlie long-term symptoms in survivors of coronavirus disease 2019 (COVID-19). Nutrition. 2021 May 1;90:111308.
  • 9) Orrù G, Bertelloni D, Diolaiuti F, Mucci F, Di Giuseppe M, Biella M, Gemignani A, Ciacchini R, Conversano C. Long-COVID Syndrome? A Study on the Persistence of Neurological, Psychological and Physiological Symptoms. Healthcare (Basel). 2021 May 13;9(5):575. 10) Martelletti P, Bentivegna E, Spuntarelli V, Luciani M. Long-COVID Headache. SN Compr Clin Med. 2021 May 20:1-3.
  • 11) Guarin G, Lo KB, Bhargav R, Salacup G, Wattoo A, Coignet JG, DeJoy R, Azmaiparashvili Z, Patarroyo-Aponte G, Eiger G, Rangaswami J. Factors associated with hospital readmissions among patients with COVID-19: A single-center experience. J Med Virol. 2021 May 27.
  • 12) Donnelly JP, Wang XQ, Iwashyna TJ, Prescott HC. Readmission and Death After Initial Hospital Discharge Among Patients With COVID-19 in a Large Multihospital System. JAMA 2021 19;325(3):304-306.

Evaluation of Readmissions after Discharged from Intensive Care Unit in Patients with Coronavirus Disease-2019

Yıl 2022, Cilt: 6 Sayı: 1, 53 - 57, 28.04.2022
https://doi.org/10.29058/mjwbs.961476

Öz

Objective: The patients who survived and discharged from the intensive care unit (ICU) after coronavirus disease-2019 (COVID-19), has been readmitted to the hospital with a various spectrum of symptoms. Being able to determine the reasons and duration of readmission time can guide post-discharge care. In this study, we aimed to analyze the rate and reasons for readmissions to the hospital in the first 60 days of Covid-19 patients discharged from the ICU.
Method: Patients admitted to a tertiari care state hospital’s ICU between March 2020- February 2021 were evaluated retrospectively. The discharge disposition, time to readmission and symptoms during readmission were recorded.
Results: A total of 145 patients were evaluated. While 89 (61%) of these patients died, 56 (39%) were discharged. It was observed that 38 of the discharged patients readmitted to the hospital, while 18 did not readmit. The mean time to first admission to the hospital was 21.34 days. The most common symptoms were dyspnea and malaise-fatigue. It was observed that patients who require mechanical ventilation during index hospitalization readmitted to the hospital with a higher rate.
Conclusion: Patients discharged from the ICU after COVID-19 have a high rate of readmission to the hospital in the first 60 days. It is important to determine the predictive factors for readmission and to identify patients who need close follow-up after discharge and for this more comprehensive studies are needed.

Kaynakça

  • 1) World Health Organization. Coronavirus Disease (COVID-19) Situation Reports. 2020. Available online: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports (accessed on 11 August 2020).
  • 2) Atalla E, Kalligeros M, Giampaolo G, Mylona EK, Shehadeh F, Mylonakis E. Readmissions among patients with COVID-19. Int J Clin Pract 2021 Mar;75(3):e13700.
  • 3) Somani SS, Richter F, Fuster V, De Freitas JK, Naik N, Sigel K, Nadkarni GN. Characterization of patients who return to hospital following discharge from hospitalization for COVID-19. J Gen Intern Med 2020 35(10), 2838-2844.
  • 4) Parra LM, Cantero M, Morrás I, Vallejo A, Diego I, Jiménez-Tejero E, Múñez E, Asensio Á, Fermández-Cruz A, Ramos-Martinez A; Puerta de Hierro Hospital Admission Study Group. Hospital Readmissions of Discharged Patients with COVID-19. Int J Gen Med 2020 Dec 2;13:1359-1366.
  • 5) Yeo I, Baek S, Kim J, Elshakh H, Voronina A, Lou MS, Vapnik J, Kaler R, Dai X, Goldbarg S. Assessment of thirty-day readmission rate, timing, causes and predictors after hospitalization with COVID-19. J Intern Med 2021 Jan Epub ahead of print.
  • 6) How to manage post-viral fatigue after COVID-19. Erişim: https://www.rcot.co.uk/how-manage-post-viral-fatigue-after-covid-19-0.
  • 7) Uyaroğlu OA, Başaran NÇ, Özişik L, Dİzman GT, Eroğlu İ, Şahİn TK, Taş Z, İnkaya AÇ, Tanriöver MD, Metan G, Güven GS, Ünal S. Thirty-day readmission rate of COVID-19 patients discharged from a tertiary care university hospital in Turkey: an observational, single-center study. Int J Qual Health Care. 2021 Feb 20;33(1):mzaa144.
  • 8) Eroğlu İ, Eroğlu BÇ, Güven GS. Altered tryptophan absorption and metabolism could underlie long-term symptoms in survivors of coronavirus disease 2019 (COVID-19). Nutrition. 2021 May 1;90:111308.
  • 9) Orrù G, Bertelloni D, Diolaiuti F, Mucci F, Di Giuseppe M, Biella M, Gemignani A, Ciacchini R, Conversano C. Long-COVID Syndrome? A Study on the Persistence of Neurological, Psychological and Physiological Symptoms. Healthcare (Basel). 2021 May 13;9(5):575. 10) Martelletti P, Bentivegna E, Spuntarelli V, Luciani M. Long-COVID Headache. SN Compr Clin Med. 2021 May 20:1-3.
  • 11) Guarin G, Lo KB, Bhargav R, Salacup G, Wattoo A, Coignet JG, DeJoy R, Azmaiparashvili Z, Patarroyo-Aponte G, Eiger G, Rangaswami J. Factors associated with hospital readmissions among patients with COVID-19: A single-center experience. J Med Virol. 2021 May 27.
  • 12) Donnelly JP, Wang XQ, Iwashyna TJ, Prescott HC. Readmission and Death After Initial Hospital Discharge Among Patients With COVID-19 in a Large Multihospital System. JAMA 2021 19;325(3):304-306.
Toplam 11 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Merve Sena Baytar 0000-0002-4829-4779

Çağdaş Baytar 0000-0001-7872-9676

Yayımlanma Tarihi 28 Nisan 2022
Kabul Tarihi 11 Şubat 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 6 Sayı: 1

Kaynak Göster

Vancouver Baytar MS, Baytar Ç. Evaluation of Readmissions after Discharged from Intensive Care Unit in Patients with Coronavirus Disease-2019. Med J West Black Sea. 2022;6(1):53-7.

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