Assessment of thirty-day readmission rate, timing, causes and predictors after hospitalization with COVID-19.

BACKGROUND: There are limited data on the characteristics of 30-day readmission after hospitalization with coronavirus disease 2019 (COVID-19). OBJECTIVES: To examine the rate, timing, causes, predictors and outcomes of 30-day readmission after COVID-19 hospitalization. METHODS: From 13 March to 9 April 2020, all patients hospitalized with COVID-19 and discharged alive were included in this retrospective observational study. Multivariable logistic regression was used to identify the predictors of 30-day readmission, and a restricted cubic spline function was utilized to assess the linearity of the association between continuous predictors and 30-day readmission. RESULTS: A total of 1062 patients were included in the analysis, with a median follow-up time of 62 days. The mean age of patients was 56.5 years, and 40.5% were women. At the end of the study, a total of 48 (4.5%) patients were readmitted within 30 days of discharge, and a median time to readmission was 5 days. The most common primary diagnosis of 30-day readmission was a hypoxic respiratory failure (68.8%) followed by thromboembolism (12.5%) and sepsis (6.3%). The patients with a peak serum creatinine level of ≥1.29 mg/dL during the index hospitalization, compared to those with a creatinine of <1.29 mg/dL, had 2.4 times increased risk of 30-day readmission (adjusted odds ratio: 2.41; 95% CI: 1.23-4.74). The mortality rate during the readmission was 22.9%. CONCLUSION: With 4.5% of the thirty-day readmission rate, COVID-19 survivors were readmitted early after hospital discharge, mainly due to morbidities of COVID-19. One in five readmitted COVID-19 survivors died during their readmission.

[Comparioson after laser surgery versus radiotherapy of T1a glottic carcinoma: A Meta-analysis].

Objective:To compare larynx preservation rate, local control rate, overall survival rate and disease-specific survival rate after laser surgery and radiotherapy of T1a glottic carcinoma. Method:PubMed, Web of Science, Embase, Cochrane Library，Chinese biomedical literature datebase,CNKI and Wanfang digital journals were searched from the built of the datebases to October 2016 by computer. Literature screening,date extraction and quality assessment were conducted independently by two co-authors,and the meta-analysis was made with Review Manager 5.3. Result:Twelve literatures were included finally, and statistical analysis results showed that radiotherapy was superior to laser surgery in the laynx preservation rate of T1a glottic carcinoma(OR=3.23，95%CI=1.21～8.60，P=0.02) , overall survival rate and specific disease survival rate were not significant different between laser surgery and radiotherapy. Conclusion:Radiotherapy is superior to laser surgery in the laynx preservation rate of T1a glottic carcinoma.