Interhospital Transfer Versus other Modes of Admission of Patients with Covid-19 at the University Hospital Andohatapenaka: A Retrospective Cohort Study
Josoa Rakotoarisoa Andrianiaina1*, Falihery Albertin Rakotomavo2, Andoniaina Rakotonaivo1, Nirina Andrianome Raharimahenina3, Francklin Rabenjarison1 and Nasolotsiry Enintsoa Raveloson2
1University Hospital of Andohatapenaka, Antananarivo, Madagascar
2University Hospital of Befelatanana, Antananario, Madagascar
3Institut National de Santé Publique et Communautaire (INSPC), Antananarivo, Madagascar
*Corresponding Author: Josoa Rakotoarisoa Andrianiaina, University Hospital of Andohatapenaka, Antananarivo, Madagascar.
Published: April 30, 2024
DOI: 10.55162/MCMS.06.212
Abstract
Background: The COVID-19 pandemic did not spare Madagascar, and we observed that a significant number of inpatients who were transferred passed away. The aim of this study was to investigate how admission by transfer influences the outcome of COVID-19 patients and to identify factors associated with mortality in patients admitted through interhospital transfer.
Methods: This is a retrospective cohort study conducted at the Andohatapenaka University Hospital over a three-month period from December 2021 to February 2022. The first group included in the study population was composed of patients from interhospital transfers (n=54). The second group consisted of patients admitted by other admission methods (n=127). The chi-square test was used to check the validity of the relative risk (RR), and the significance threshold was set by a p value < 0.05.
Results: After analysis, it was found that the mode of admission interhospital transfer was associated with patient mortality (RR=1.47 [1.06-2.04]). Additionally, we identified several factors associated with mortality in COVID-19 patients, including a history of diabetes (RR=1.58[1.02-2.43]), a respiratory rate of more than 30 cycles/min (RR=1.58[1.02-2.45]), SpO2 less than or equal to 88% (RR=2.45[1.21-4.92]), Glasgow score between 9 and 12 (RR=2.09[1.55-2.83]), critical form (RR=2.41 [1.68-3.47]), lung involvement greater than 50% (RR=1.99 [1.05-3.74]), presence of complications (RR=1.90 [1.24-2.93]), complications by myocardial infarction (RR=2.00 [1.50-2.65]), and use of noninvasive ventilation (RR=2.00 [1.50-2.65]). Therefore, admission through interhospital transfer influenced the unfavorable patient outcome.
Conclusion: Our study shows that admission by transfer is associated with mortality in COVID-19 patients. We recommend that healthcare professionals exercise vigilance in managing these patients to improve outcomes.
Keywords: admission; COVID-19; mortality; transfer
.