{"pk":17408,"title":"Characteristics of Suspected COVID-19 Discharged Emergency Department Patients Who Returned During the First Wave","subtitle":null,"abstract":"Introduction:\n Limited information exists on patients with suspected coronavirus disease 2019 (COVID-19) who return to the emergency department (ED) during the first wave. In this study we aimed to identify predictors of ED return within 72 hours for patients with suspected COVID-19.\nMethods:\n Incorporating data from 14 EDs within an integrated healthcare network in the New York metropolitan region from March 2–April 27, 2020, we analyzed this data on predictors for a return ED visit—including demographics, comorbidities, vital signs, and laboratory results.\nResults:\n In total, 18,599 patients were included in the study. The median age was 46 years old [interquartile range 34-58]), 50.74% were female, and 49.26% were male. Overall, 532 (2.86%) returned to the ED within 72 hours, and 95.49% were admitted at the return visit. Of those tested for COVID-19, 59.24% (4704/ 7941) tested positive. Patients with chief complaints of “fever” or “flu” or a history of diabetes or renal disease were more likely to return at 72 hours. Risk of return increased with persistently abnormal temperature (odds ratio [OR] 2.43, 95% CI 1.8-3.2), respiratory rate (2.17, 95% CI 1.6-3.0), and chest radiograph (OR 2.54, 95% CI 2.0-3.2). Abnormally high neutrophil counts, low platelet counts, high bicarbonate values, and high aspartate aminotransferase levels were associated with a higher rate of return. Risk of return decreased when discharged on antibiotics (OR 0.12, 95% CI 0.0-0.3) or corticosteroids (OR 0.12, 95% CI 0.0-0.9).\nConclusion: \nThe low overall return rate of patients during the first COVID-19 wave indicates that physicians’ clinical decision-making successfully identified those acceptable for discharge.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Readmission, COVID-19, 72-hour return"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1rp7b530","frozenauthors":[{"first_name":"Jonathan","middle_name":"","last_name":"Gong","name_suffix":"","institution":"Zucker School of Medicine at Hofstra/Northwell, Long Island Jewish Medical Center, Department of Emergency Medicine, New Hyde Park, New York","department":"None"},{"first_name":"Rene","middle_name":"","last_name":"Mayorga","name_suffix":"","institution":"Northwell Health, Emergency Medicine Service Line, New Hyde Park, New York","department":"None"},{"first_name":"Roland","middle_name":"","last_name":"Hentz","name_suffix":"","institution":"Feinstein Institute for Medical Research, Biostatistics Unit, Great Neck, New York","department":"None"},{"first_name":"Martin","middle_name":"","last_name":"Lesser","name_suffix":"","institution":"Feinstein Institute for Medical Research, Biostatistics Unit, Great Neck, New York; Zucker School of Medicine at Hofstra/Northwell, Department of Molecular Medicine & Department of Population Health, Hempstead, New York","department":"None"},{"first_name":"Seleshi","middle_name":"","last_name":"Demissie","name_suffix":"","institution":"Feinstein Institute for Medical Research, Biostatistics Unit, Great Neck, New York","department":"None"},{"first_name":"Frederick","middle_name":"","last_name":"Davis","name_suffix":"","institution":"Zucker School of Medicine at Hofstra/Northwell, Long Island Jewish Medical Center, Department of Emergency Medicine, New Hyde Park, New York","department":"None"},{"first_name":"Adam","middle_name":"","last_name":"Berman","name_suffix":"","institution":"Zucker School of Medicine at Hofstra/Northwell, Long Island Jewish Medical Center, Department of Emergency Medicine, New Hyde Park, New York","department":"None"},{"first_name":"Matthew","middle_name":"","last_name":"Barish","name_suffix":"","institution":"Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Department of Radiology, Hempstead, New York","department":"None"},{"first_name":"Stuart","middle_name":"L.","last_name":"Cohen, MD","name_suffix":"","institution":"Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Department of Radiology, Hempstead, New York","department":"None"},{"first_name":"Kate","middle_name":"L.","last_name":"van Loveren","name_suffix":"","institution":"Zucker School of Medicine at Hofstra/Northwell, Long Island Jewish Medical Center, Department of Emergency Medicine, New Hyde Park, New York","department":"None"},{"first_name":"Nancy","middle_name":"S.","last_name":"Kwon","name_suffix":"","institution":"Zucker School of Medicine at Hofstra/Northwell, Long Island Jewish Medical Center, Department of Emergency Medicine, New Hyde Park, New York","department":"None"},{"first_name":"Northwell","middle_name":"","last_name":"COVID-19 Research Consortium","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2022-09-01T03:12:00Z","date_accepted":"2022-09-01T03:12:00Z","date_published":"2023-04-03T17:29:22Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/17408/galley/8855/download/"}]}