Risco de readmissão ao departamento de emergência em pacientes ambulatoriais com COVID-19 leve com acompanhamento de telessaúde
DOI:
https://doi.org/10.31053/1853.0605.v78.n3.32414Palavras-chave:
serviços médicos de emergência, infecções por coronavirus, assistência ambulatorial, telemedicina, readmissão do pacienteResumo
Introdução: Descrever as características dos pacientes com COVID-19 com sintomas leves e alta do Centro de Emergência de Adultos (CEA) e acompanhados ambulatorialmente por telemedicina. Estime as taxas de nova consulta ao CEA e de hospitalização e explore os fatores associados a esses resultados.
Métodos: Coorte retrospectiva de junho a agosto de 2020 no Hospital Italiano de Buenos Aires, que incluiu COVID-19 com sintomas leves. Eles foram acompanhados por 14 dias até a ocorrência de nova consulta no CEA e / ou internação. Modelos de Kaplan-Meier e regressão logística foram usados.
Resultados: De um total de 1.239 pacientes, com mediana de 41 anos e 53,82% homens, 167 pacientes consultaram novamente o CEA, com uma taxa de incidência global em 14 dias de 13,08% (IC95% 11,32 a 15,08). Destes, 83 necessitaram de hospitalização (média de 4,98 dias), 6% não estavam relacionados com COVID-19 e 5 pacientes morreram. Após o ajuste para fatores de confusão (idade ≥65, sexo, diabetes, hipertensão, ex-tabagismo, tabagismo ativo, febre, diarreia e saturação de oxigênio), encontramos associações significativas: tabagismo prévio (ORa 2,09, IC 95% 1,31-3,34, p0 = 0,002), febre (ORa 1,56, IC 95% 1,07-2,28, p = 0,002) e saturação de oxigênio (ORa 0,82, IC 95% 0,71-0,95, p = 0,009).
Conclusão: A taxa de 13% de re-consulta ao CEA durante 14 dias de seguimento foi muito significativa para a gestão hospitalar, qualidade do desempenho e segurança do paciente.
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