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Defining Incidental Versus Non-incidental COVID-19 Hospitalizations.
Nikolla, Dhimitri A; Oskvarek, Jonathan J; Zocchi, Mark S; Rahman, Nishad A; Leubitz, Andrew; Moghtaderi, Ali; Black, Bernard S; Pines, Jesse M.
Afiliación
  • Nikolla DA; Department of Internal Medicine / Emergency Medicine, Lake Erie College of Osteopathic Medicine, Erie, USA.
  • Oskvarek JJ; Department of Emergency Medicine, Allegheny Health Network, Erie, USA.
  • Zocchi MS; US Acute Care Solutions (USACS) Research Group, US Acute Care Solutions, Canton, USA.
  • Rahman NA; Department of Emergency Medicine, Summa Health System, Akron, USA.
  • Leubitz A; US Acute Care Solutions (USACS) Research Group, US Acute Care Solutions, Canton, USA.
  • Moghtaderi A; Heller School for Social Policy and Management, Brandeis University, Waltham, USA.
  • Black BS; US Acute Care Solutions (USACS) Research Group, US Acute Care Solutions, Canton, USA.
  • Pines JM; Department of Emergency Medicine, LifeBridge Health - Sinai Hospital, Baltimore, USA.
Cureus ; 16(3): e56546, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38646211
ABSTRACT
Background Rates of COVID-19 hospitalization are an important measure of the health system burden of severe COVID-19 disease and have been closely followed throughout the pandemic. The highly transmittable, but often less severe, Omicron COVID-19 variant has led to an increase in hospitalizations with incidental COVID-19 diagnoses where COVID-19 is not the primary reason for admission. There is a strong public health need for a measure that is implementable at low cost with standard electronic health record (EHR) datasets that can separate these incidental hospitalizations from non-incidental hospitalizations where COVID-19 is the primary cause or an important contributor. Two crude metrics are in common use. The first uses in-hospital administration of dexamethasone as a marker of non-incidental COVID-19 hospitalizations. The second, used by the United States (US) CDC, relies on a limited set of COVID-19-related diagnoses (i.e., respiratory failure, pneumonia). Both measures likely undercount non-incidental COVID-19 hospitalizations. We therefore developed an improved EHR-based measure that is better able to capture the full range of COVID-19 hospitalizations. Methods We conducted a retrospective study of ED visit data from a national emergency medicine group from April 2020 to August 2023. We assessed the CDC approach, the dexamethasone-based measure, and alternative approaches that rely on co-diagnoses likely to be related to COVID-19, to determine the proportion of non-incidental COVID-19 hospitalizations. Results Of the 153,325 patients diagnosed with COVID-19 at 112 general EDs in 17 US states, and admitted or transferred, our preferred measure classified 108,243 (70.6%) as non-incidental, compared to 71,066 (46.3%) using the dexamethasone measure and 77,399 (50.5%) using the CDC measure. Conclusions Identifying non-incidental COVID-19 hospitalizations using ED administration of dexamethasone or the CDC measure provides substantially lower estimates than our preferred measure.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cureus Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cureus Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos