Buscar en
Medicina Clínica (English Edition)
Toda la web
Inicio Medicina Clínica (English Edition) Radiography-based triage for COVID-19 in the Emergency Department in a Spanish c...
Journal Information
Vol. 158. Issue 10.
Pages 466-471 (May 2022)
Share
Share
Download PDF
More article options
ePub
Visits
192
Vol. 158. Issue 10.
Pages 466-471 (May 2022)
Original article
Radiography-based triage for COVID-19 in the Emergency Department in a Spanish cohort of patients
Sistema de selección en urgencias de pacientes con sospecha de infección por SARS-CoV-2 y con posible neumonía no graves basado en la radiografía de tórax
Visits
192
Abiu Sempere-Gonzáleza, Jordi Llaneras-Artiguesa, Iago Pinal-Fernándezb,c,d, Esperanza Cañas-Ruanoa, Olimpia Orozco-Gálveza, Eva Domingo-Baldricha, Xabier Michelenaa, Beatriz Mezaa, Eloi García-Vivesa, Albert Gil-Vilaa, Javier Sarrapio-Lorenzoa, Sheila Romero-Rupertoa, Francesc Sanpedro-Jiméneza, María Arranz-Betegóna, Andreu Fernández-Codinaa,e,
Corresponding author
a Emergency Department, University Hospital Vall d’Hebron, Barcelona, Spain
b National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MA, USA
c Johns Hopkins University School of Medicine, Baltimore, MD, USA
d Faculty of Health Sciences and Faculty of Computer Science, Multimedia and Telecommunications, Universitat Oberta de Catalunya, Barcelona, Spain
e Rheumatology Division and General Internal Medicine Division-Windsor Campus, University of Western Ontario, London/Windsor, ON, Canada
This item has received
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Abstract
Background

Strategies to determine who could be safely discharged home from the Emergency Department (ED) in COVID-19 are needed to decongestion healthcare systems.

Objectives

To describe the outcomes of an ED triage system for non-severe patients with suspected COVID-19 and possible pneumonia based on chest X-ray (CXR) upon admission.

Material and methods

Retrospective, single-center study performed in Barcelona (Spain) during the COVID-19 peak in March–April 2020. Patients with COVID-19 symptoms and potential pneumonia, without respiratory insufficiency, with priority class IV–V (Andorran triage model) had a CXR upon admission. This approach tried to optimize resource use and to facilitate discharges. The results after adopting this organizational approach are reported.

Results

We included 834 patients, 53% were female. Most patients were white (66%) or Hispanic (27%). CXR showed pneumonia in 523 (62.7%). Compared to those without pneumonia, patients with pneumonia were older (55 vs 46.6 years old) and had a higher Charlson comorbidity index (1.9 vs 1.3). Patients with pneumonia were at a higher risk for a combined outcome of admission and/or death (91 vs 12%). Death rates tended to be numerically higher in the pneumonia group (10 vs 1). Among patients without pneumonia in the initial CXR, 10% reconsulted (40% of them with new pneumonia).

Conclusion

CXR identified pneumonia in a significant number of patients. Those without pneumonia were mostly discharged. Mortality among patients with an initially negative CXR was low. CXR triage for pneumonia in non-severe COVID-19 patients in the ED can be an effective strategy to optimize resource use.

Keywords:
COVID-19
Pneumonia
Triage
Emergency
Radiography
Resumen
Introducción

La pandemia de COVID-19 conlleva una alta ocupación de los servicios de urgencias (SU). Se requieren nuevas estrategias para optimizar la gestión de estos recursos.

Objetivos

Describir los resultados de un sistema de triaje en urgencias para pacientes no graves con sospecha de COVID-19 y posible neumonía, basado en la radiografía de tórax (RT).

Material y métodos

Estudio retrospectivo, unicéntrico realizado en Barcelona (España) entre marzo y abril de 2020. Se realizó una RT al ingreso en SU de pacientes con síntomas de COVID-19 y sospecha de neumonía, sin insuficiencia respiratoria, con una prioridad clase IV-V (sistema andorrano de triaje). Esta medida pretende optimizar los recursos y facilitar las altas. Se reportan los resultados tras adoptar esta estrategia.

Resultados

Se incluyeron 834 pacientes (53% mujeres, 66% caucásicos, 27% hispánicos). La RT mostró neumonía en 523 (62,7%). Comparados con los pacientes sin neumonía, los que sí la padecían eran mayores (55 vs. 46,6 años), con un índice de comorbilidad de Charlson más elevado (1,9 vs. 1,3) y con mayor riesgo de ingreso y/o muerte (91 vs. 12%). La mortalidad fue numéricamente mayor en el grupo con neumonía (10 vs. 1). El 10% de los pacientes sin neumonía en RT consultaron de nuevo al SU (40% con neumonía).

Conclusión

La RT identificó neumonía en múltiples pacientes. Los que no tenían neumonía fueron mayoritariamente dados de alta. La mortalidad entre pacientes con RT negativa fue baja. La RT como triaje para neumonía en pacientes con COVID-19 no grave puede ahorrar recursos.

Palabras clave:
COVID-19
Neumonía
Triaje
Emergencias
Radiografía

Article

These are the options to access the full texts of the publication Medicina Clínica (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Medicina Clínica (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

Quizás le interese:
10.1016/j.medcle.2021.05.024
No mostrar más