The following is a summary of “Home oxygen therapy from the emergency department for COVID-19 an observational study,” published in the June 2023 issue of Emergency Medicine by Schoenling, et al.
For a study, researchers sought to evaluate the outcomes of COVID-19 patients who were discharged from the Emergency Department (ED) with home oxygen as part of a program aimed at reducing hospital admissions during the COVID-19 pandemic.
A retrospective analysis was conducted on COVID-19 patients who visited the ED and were directly discharged or placed under observation from April 2020 to January 2022 in a healthcare system comprising 14 hospitals. The study cohort included patients who were discharged with new oxygen supplementation, a pulse oximeter, and return instructions. The primary outcome assessed was subsequent hospitalization or death outside the hospital within 30 days of ED or observation discharge.
Among the 28,960 patients who visited the ED for COVID-19, 11,508 (39.7%) were admitted to the hospital, 907 (3.1%) were placed in observation status, and 16,545 (57.1%) were discharged to home. A total of 614 COVID-19 patients (535 discharged to home and 97 in the observation unit) were sent home with new oxygen therapy. The primary outcome occurred in 151 patients (24.6%, CI 21.3–28.1%). Out of these, 148 patients (24.1%) were subsequently hospitalized, and 3 patients (0.5%) died outside the hospital. The subsequent hospitalized mortality rate was 29.7%, with 44 out of the 148 hospitalized patients dying. The overall all-cause mortality rate at 30 days in the entire cohort was 7.7%.
The findings suggested that the majority of COVID-19 patients who were discharged to home with new oxygen therapy were able to avoid hospitalization, and the rate of mortality within 30 days was relatively low. It indicated the feasibility of implementing such an approach and supported further research and implementation efforts in the area.