Grannec, F.; Meddeb, L.; Tissot-Dupont, H.; Gentile, S.; Brouqui, P. Pre-Hospital Management of Patients with COVID-19 and the Impact on Hospitalization. Medicina2023, 59, 1440.
Grannec, F.; Meddeb, L.; Tissot-Dupont, H.; Gentile, S.; Brouqui, P. Pre-Hospital Management of Patients with COVID-19 and the Impact on Hospitalization. Medicina 2023, 59, 1440.
Grannec, F.; Meddeb, L.; Tissot-Dupont, H.; Gentile, S.; Brouqui, P. Pre-Hospital Management of Patients with COVID-19 and the Impact on Hospitalization. Medicina2023, 59, 1440.
Grannec, F.; Meddeb, L.; Tissot-Dupont, H.; Gentile, S.; Brouqui, P. Pre-Hospital Management of Patients with COVID-19 and the Impact on Hospitalization. Medicina 2023, 59, 1440.
Abstract
Context. During the COVID-19 pandemic, patient care was mainly organised around the hospital. Pre-hospital care has, to our knowledge, never been evaluated. Objective: To evaluate the impact of pre-hospital pathways on hospitalisation during the last part of the pandemic. Design. This was a monocentric retrospective analysis of prospectively collected medical records. Data from patients admitted to our institute between 1 February and 7 March 2022 were analysed. Main Outcome Measure(s): The primary outcomes were defined as the number of hospitalisations, resuscitations, and deaths at the time of interview and in the subsequent 30 days. The main explanatory variables were times from onset of symptoms to care, age, gender, News2 score, comorbidities, and pre-hospital pathways and their duration. Results: Three pre-hospital pathways have been identified: a pathway in which the patient consults a general practitioner for a test (PHP1); a pathway in which the patient consulted for care (PHP2); and no pre-hospital pathway and direct admission to hospital (PHP3). Factors independently associated with outcome (hospitalisation) were being male (OR 95% CI; 2.21 [1.01–4.84], p=0,04), News2 score (OR 95% CI; 2.04 [1.65–2.51], p<0.001), obesity (OR 95% CI; 3.45 [1.48–8.09], p=0.005), D-dimers > 0.5 µg/ml (OR 95% CI; 3.45 [1.47–8.12], p=0.005), prolonged time from symptoms to hospital care (PHP duration) (OR 95% CI; 1.07 [1.01–1.14], p=0.03). All things being equal, patients with a “PHP2” pre-hospital pathway had a higher probability of hospitalisation compared to those with a “PHP3” pre-hospital pathway (OR 95% CI; 4.31 [1.48–12.55], p=0.007). Conclusions. Along with recognised risk factors such as gender, News 2 score, and obesity, the patient’s pre-hospital pathway is an important risk factor associated with hospitalisation.
Public Health and Healthcare, Public Health and Health Services
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