COVID-19 second wave: appropriateness of admissions to the Emergency Department of a main metropolitan hospital in Milan

COVID-19 second wave: appropriateness of admissions to the Emergency Department of a main metropolitan hospital in Milan

Authors

  • Eleonora Bossi Università Vita Salute San Raffaele, IRCCS Ospedale San Raffaele
  • Vincenza Gianfredi Università Vita Salute San Raffaele, IRCCS Ospedale San Raffaele
  • Anna Odone Università degli studi di Pavia, IRCCS Ospedale San Raffaele
  • Davide Valsecchi IRCCS Ospedale San Raffaele
  • Stefano Franchini IRCCS Ospedale San Raffaele
  • Massimiliano Etteri IRCCS Ospedale San Raffaele
  • Guglielmo Cornero IRCCS Ospedale San Raffaele
  • Giuseppina Maria Casiraghi IRCCS Ospedale San Raffaele
  • Nicolò Maimeri Università Vita Salute San Raffaele, IRCCS Ospedale San Raffaele
  • Paolo Federico Beccaria IRCCS Ospedale San Raffaele
  • Elena Moizo IRCCS Ospedale San Raffaele
  • Milena Mucci IRCCS Ospedale San Raffaele
  • Paolo Silvani IRCCS Ospedale San Raffaele
  • Valentina Paola Plumari IRCCS Ospedale San Raffaele
  • Giovanni Borghi IRCCS Ospedale San Raffaele
  • Nicola Pasculli IRCCS Ospedale San Raffaele
  • Alessia La Bruna IRCCS Ospedale San Raffaele
  • Martina Baiardo Redaelli IRCCS Ospedale San Raffaele
  • Antonio Dell'Acqua IRCCS Ospedale San Raffaele
  • Maria Luisa Azzolini IRCCS Ospedale San Raffaele
  • Francesca Guzzo IRCCS Ospedale San Raffaele
  • Ada Carla Alba IRCCS Ospedale San Raffaele
  • Stella Sordoni Università Vita Salute San Raffaele, IRCCS Ospedale San Raffaele
  • Margherita Tozzi Università Vita Salute San Raffaele, IRCCS Ospedale San Raffaele
  • Francesco Giuseppe Nisi Università Vita Salute San Raffaele, IRCCS Ospedale San Raffaele
  • Stefano Fresilli Università Vita Salute San Raffaele, IRCCS Ospedale San Raffaele
  • Alberto Zangrillo Università Vita Salute San Raffaele, IRCCS Ospedale San Raffaele
  • Carlo Signorelli Università Vita Salute San Raffaele, IRCCS Ospedale San Raffaele

Keywords:

SARS-Cov-2, COVID-19, Emergency Department, Emergency Room, Appropriateness

Abstract

Background: In Europe, Italy and Lombardy, in autumn 2020, there was a steep increase in reported cases due to the second epidemic wave of SARS-Cov-2 infection. We aimed to evaluate the appropriateness of COVID-19 patients’ admissions to the ED of the San Raffaele Hospital.

Methods: We compared data between the inter-wave period (IWP, from 1st to 30th September) and the second wave period (WP, 1st October to 15th November) focusing on the ED presentation, discharge priority colour code and outcomes.

Results: Out of 977 admissions with a SARS-Cov-2 positive swab, 6% were in the IWP and 94% in the WP. Red, yellow and white code increased (these latter from 1.8% to 5.4%) as well as self-presented in yellow and white code. Discharges home increased from 1.8% to 5.4%, while hospitalizations decreased from 63% to 51%.

Discussion: We found a rise in white codes (among self-presented patients), indicating inappropriateness of admissions. The increase in discharges suggests that several patients did not require hospitalization.

Conclusions: The pandemic brought out the fundamental role of primary care to manage patients with low-intensity needs. The important increase in ED admissions of COVID-19 patients caused a reduction of NO-COVID-19 patients, with possible inadequate treatment.

 

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Published

01-10-2021

How to Cite

1.
COVID-19 second wave: appropriateness of admissions to the Emergency Department of a main metropolitan hospital in Milan. Acta Biomed [Internet]. 2021 Oct. 1 [cited 2024 May 19];92(S6):e2021419. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/12244

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