Emergency department bounceback characteristics for patients diagnosed with COVID-19
The global healthcare burden of COVID-19 continues to rise. There is currently limited information regarding the disease progression and the need for hospitalizations in patients who present to the Emergency Department (ED) with minimal or no symptoms. This study identifies bounceback rates and time...
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| Veröffentlicht in: | The American journal of emergency medicine 2021-09, Vol.47, p.239-243 |
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| container_title | The American journal of emergency medicine |
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| creator | Haag, Adam Dhake, Sarah S. Folk, Jessica Ravichadran, Urmila Maric, Andrea Donlan, Sarah Konchak, Chad Au, Loretta Shah, Nirav S. Wang, Ernest |
| description | The global healthcare burden of COVID-19 continues to rise. There is currently limited information regarding the disease progression and the need for hospitalizations in patients who present to the Emergency Department (ED) with minimal or no symptoms.
This study identifies bounceback rates and timeframes for patients who return to the ED due to COVID-19 after initial discharge on the date of testing.
Using the NorthShore University Health System's (NSUHS) Enterprise Data Warehouse (EDW), we conducted a retrospective cohort analysis of patients who were tested positive for COVID-19 and were discharged home on the date of testing. A one-month follow-up period was included to ensure the capture of disease progression.
Of 1883 positive cases with initially mild symptoms, 14.6% returned to the ED for complaints related to COVID-19. 56.9% of the mildly symptomatic bounceback patients were discharged on the return visit while 39.5% were admitted to the floor and 3.6% to the ICU. Of the 1120 positive cases with no initial symptoms, only four returned to the ED (0.26%) and only one patient was admitted. Median initial testing occurred on day 3 (2–5.6) of illness, and median ED bounceback occurred on day 9 (6.3–12.7). Our statistical model was unable to identify risk factors for ED bouncebacks.
COVID-19 patients diagnosed with mild symptoms on initial presentation have a 14.6% rate of bounceback due to progression of illness. |
| doi_str_mv | 10.1016/j.ajem.2021.04.050 |
| format | Article |
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This study identifies bounceback rates and timeframes for patients who return to the ED due to COVID-19 after initial discharge on the date of testing.
Using the NorthShore University Health System's (NSUHS) Enterprise Data Warehouse (EDW), we conducted a retrospective cohort analysis of patients who were tested positive for COVID-19 and were discharged home on the date of testing. A one-month follow-up period was included to ensure the capture of disease progression.
Of 1883 positive cases with initially mild symptoms, 14.6% returned to the ED for complaints related to COVID-19. 56.9% of the mildly symptomatic bounceback patients were discharged on the return visit while 39.5% were admitted to the floor and 3.6% to the ICU. Of the 1120 positive cases with no initial symptoms, only four returned to the ED (0.26%) and only one patient was admitted. Median initial testing occurred on day 3 (2–5.6) of illness, and median ED bounceback occurred on day 9 (6.3–12.7). Our statistical model was unable to identify risk factors for ED bouncebacks.
COVID-19 patients diagnosed with mild symptoms on initial presentation have a 14.6% rate of bounceback due to progression of illness.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2021.04.050</identifier><identifier>PMID: 33945978</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Asymptomatic ; Bounceback rates ; Coronavirus ; Coronaviruses ; COVID-19 ; COVID-19 - epidemiology ; COVID-19 diagnostic tests ; Emergency department ; Emergency medical care ; Emergency medical services ; Emergency Service, Hospital - statistics & numerical data ; Female ; Global health ; Health Services Accessibility ; Hospital systems ; Hospitals ; Humans ; Illinois - epidemiology ; Logistic Models ; Male ; Mathematical models ; Medical diagnosis ; Middle Aged ; Pandemics ; Patient Readmission - statistics & numerical data ; Patients ; Public health ; Retrospective Studies ; Risk Assessment ; Risk Factors ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2 ; Severity of Illness Index ; Statistical models</subject><ispartof>The American journal of emergency medicine, 2021-09, Vol.47, p.239-243</ispartof><rights>2021</rights><rights>Published by Elsevier Inc.</rights><rights>Copyright Elsevier Limited Sep 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-1c34052acc171425210cd66b4355922c802476e46a64fa4a6438df8d9ab0fbb63</citedby><cites>FETCH-LOGICAL-c483t-1c34052acc171425210cd66b4355922c802476e46a64fa4a6438df8d9ab0fbb63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2560289934?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33945978$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Haag, Adam</creatorcontrib><creatorcontrib>Dhake, Sarah S.</creatorcontrib><creatorcontrib>Folk, Jessica</creatorcontrib><creatorcontrib>Ravichadran, Urmila</creatorcontrib><creatorcontrib>Maric, Andrea</creatorcontrib><creatorcontrib>Donlan, Sarah</creatorcontrib><creatorcontrib>Konchak, Chad</creatorcontrib><creatorcontrib>Au, Loretta</creatorcontrib><creatorcontrib>Shah, Nirav S.</creatorcontrib><creatorcontrib>Wang, Ernest</creatorcontrib><title>Emergency department bounceback characteristics for patients diagnosed with COVID-19</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>The global healthcare burden of COVID-19 continues to rise. There is currently limited information regarding the disease progression and the need for hospitalizations in patients who present to the Emergency Department (ED) with minimal or no symptoms.
This study identifies bounceback rates and timeframes for patients who return to the ED due to COVID-19 after initial discharge on the date of testing.
Using the NorthShore University Health System's (NSUHS) Enterprise Data Warehouse (EDW), we conducted a retrospective cohort analysis of patients who were tested positive for COVID-19 and were discharged home on the date of testing. A one-month follow-up period was included to ensure the capture of disease progression.
Of 1883 positive cases with initially mild symptoms, 14.6% returned to the ED for complaints related to COVID-19. 56.9% of the mildly symptomatic bounceback patients were discharged on the return visit while 39.5% were admitted to the floor and 3.6% to the ICU. Of the 1120 positive cases with no initial symptoms, only four returned to the ED (0.26%) and only one patient was admitted. Median initial testing occurred on day 3 (2–5.6) of illness, and median ED bounceback occurred on day 9 (6.3–12.7). Our statistical model was unable to identify risk factors for ED bouncebacks.
COVID-19 patients diagnosed with mild symptoms on initial presentation have a 14.6% rate of bounceback due to progression of illness.</description><subject>Adult</subject><subject>Aged</subject><subject>Asymptomatic</subject><subject>Bounceback rates</subject><subject>Coronavirus</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 diagnostic tests</subject><subject>Emergency department</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Emergency Service, Hospital - statistics & numerical data</subject><subject>Female</subject><subject>Global health</subject><subject>Health Services Accessibility</subject><subject>Hospital systems</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Illinois - epidemiology</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Mathematical models</subject><subject>Medical diagnosis</subject><subject>Middle Aged</subject><subject>Pandemics</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Patients</subject><subject>Public health</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Severity of Illness Index</subject><subject>Statistical models</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kc1u1DAURi1ERYfCC7BAkdiwSer_xBJCQkOBSpW6KWwtx76ZcZjEg-0U9e3xaEpFu2BjL3z86bv3IPSG4IZgIs_HxowwNRRT0mDeYIGfoRURjNYdaclztMItE7VsRXuKXqY0YkwIF_wFOmVMcaHaboVuLiaIG5jtXeVgb2KeYM5VH5bZQm_sz8puTTQ2Q_Qpe5uqIcRqb7IvWKqcN5s5JHDVb5-31fr6x-XnmqhX6GQwuwSv7-8z9P3Lxc36W311_fVy_emqtrxjuSaWcSyosbbU5VRQgq2TsudMCEWp7TDlrQQujeSD4eVknRs6p0yPh76X7Ax9PObul34CZ0unaHZ6H_1k4p0OxuvHL7Pf6k241R0WZRFtCXh_HxDDrwVS1pNPFnY7M0NYki6dKFNMSVHQd0_QMSxxLuMVSmLaKcV4oeiRsjGkFGF4KEOwPkjToz5I0wdpGnNdpJVPb_8d4-HLX0sF-HAEoCzz1kPUyRYBFpyPYLN2wf8v_w9FP6hH</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Haag, Adam</creator><creator>Dhake, Sarah S.</creator><creator>Folk, Jessica</creator><creator>Ravichadran, Urmila</creator><creator>Maric, Andrea</creator><creator>Donlan, Sarah</creator><creator>Konchak, Chad</creator><creator>Au, Loretta</creator><creator>Shah, Nirav S.</creator><creator>Wang, Ernest</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><general>W B Saunders</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210901</creationdate><title>Emergency department bounceback characteristics for patients diagnosed with COVID-19</title><author>Haag, Adam ; Dhake, Sarah S. ; Folk, Jessica ; Ravichadran, Urmila ; Maric, Andrea ; Donlan, Sarah ; Konchak, Chad ; Au, Loretta ; Shah, Nirav S. ; Wang, Ernest</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-1c34052acc171425210cd66b4355922c802476e46a64fa4a6438df8d9ab0fbb63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Asymptomatic</topic><topic>Bounceback rates</topic><topic>Coronavirus</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Haag, Adam</au><au>Dhake, Sarah S.</au><au>Folk, Jessica</au><au>Ravichadran, Urmila</au><au>Maric, Andrea</au><au>Donlan, Sarah</au><au>Konchak, Chad</au><au>Au, Loretta</au><au>Shah, Nirav S.</au><au>Wang, Ernest</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Emergency department bounceback characteristics for patients diagnosed with COVID-19</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>47</volume><spage>239</spage><epage>243</epage><pages>239-243</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><abstract>The global healthcare burden of COVID-19 continues to rise. There is currently limited information regarding the disease progression and the need for hospitalizations in patients who present to the Emergency Department (ED) with minimal or no symptoms.
This study identifies bounceback rates and timeframes for patients who return to the ED due to COVID-19 after initial discharge on the date of testing.
Using the NorthShore University Health System's (NSUHS) Enterprise Data Warehouse (EDW), we conducted a retrospective cohort analysis of patients who were tested positive for COVID-19 and were discharged home on the date of testing. A one-month follow-up period was included to ensure the capture of disease progression.
Of 1883 positive cases with initially mild symptoms, 14.6% returned to the ED for complaints related to COVID-19. 56.9% of the mildly symptomatic bounceback patients were discharged on the return visit while 39.5% were admitted to the floor and 3.6% to the ICU. Of the 1120 positive cases with no initial symptoms, only four returned to the ED (0.26%) and only one patient was admitted. Median initial testing occurred on day 3 (2–5.6) of illness, and median ED bounceback occurred on day 9 (6.3–12.7). Our statistical model was unable to identify risk factors for ED bouncebacks.
COVID-19 patients diagnosed with mild symptoms on initial presentation have a 14.6% rate of bounceback due to progression of illness.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33945978</pmid><doi>10.1016/j.ajem.2021.04.050</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Asymptomatic Bounceback rates Coronavirus Coronaviruses COVID-19 COVID-19 - epidemiology COVID-19 diagnostic tests Emergency department Emergency medical care Emergency medical services Emergency Service, Hospital - statistics & numerical data Female Global health Health Services Accessibility Hospital systems Hospitals Humans Illinois - epidemiology Logistic Models Male Mathematical models Medical diagnosis Middle Aged Pandemics Patient Readmission - statistics & numerical data Patients Public health Retrospective Studies Risk Assessment Risk Factors SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Severity of Illness Index Statistical models |
| title | Emergency department bounceback characteristics for patients diagnosed with COVID-19 |
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