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COVID Oximetry @home: evaluation of patient outcomes

COVID Oximetry @home: evaluation of patient outcomes
COVID Oximetry @home: evaluation of patient outcomes
Background COVID-19 has placed unprecedented demands on hospitals. A clinical service, COVID Oximetry @home (CO@h) was launched in November 2020 to support remote monitoring of COVID-19 patients in the community. Remote monitoring through CO@h aims to identify early patient deterioration and provide timely escalation for cases of silent hypoxia, while reducing the burden on secondary care. Methods We conducted a retrospective service evaluation of COVID-19 patients onboarded to CO@h from November 2020 to March 2021 in the North Hampshire (UK) community led service (a collaboration of 15 GP practices, covering a population of 230,000 people). We have compared outcomes for patients admitted to Basingstoke & North Hampshire Hospital who were CO@h patients (COVID-19 patients with monitoring of SpO2 (n=137)), with non CO@h patients (those directly admitted without being monitored by CO@h (n=633)). Odds Ratio analysis was performed to contrast the likelihood of patient outcomes resulting in 30 day mortality, ICU admission and length of stay greater than 3, 7, 14, and 28 days. Results Hospital length of stay was reduced by an average of 6.3 days for CO@h patients (6.9 95% CI [5.6 - 8.1]) in comparison to Non-CO@h (13.2 95% CI [12.2 - 14.1]). The most significant odds ratio effect was on mortality (0.23 95%CI [0.11 - 0.49]), followed by length of stay > 14 days (OR 0.23 95%CI [0.13 - 0.42]), length of stay > 28 days (OR 0.23 95%CI [0.08 - 0.65]), length of stay > 7 days (OR 0.35 95%CI [0.24 - 0.52]), and length of stay > 3 days (OR 0.52 95%CI [0.35 - 0.78]). Mortality and length of stay outcomes were statistically significant. Only 5/137 (3.6%) where admitted to ICU compared with 52/633 (8.2%) for Non-CO@h. Conclusions CO@h has demonstrated considerably improved patient outcomes reducing the odds of longer length hospital stays and mortality.
Boniface, Michael
f30bfd7d-20ed-451b-b405-34e3e22fdfba
Burns, Daniel
40b9dc88-a54a-4365-b747-4456d9203146
Duckworth, Chris
992c216c-8f66-48a8-8de6-2f04b4f736e6
Duruiheoma, Franklin
bd050a22-85bc-49ae-8d39-b97e0f08453b
Armitage, Htwe
f20a9e2d-1b62-4f17-8e9c-bfd6a0e0589f
Ratcliffe, Naomi
f10be2f5-bcd9-49ab-9967-ae421f977b7d
Duffy, John
c0e4f8e0-72e4-4aa8-83d2-74cec233179c
O’Keeffe, Caroline
879cfd52-02e7-406e-b974-ca9bd5de07f2
Inada-Kim, Matt
eaac8cc7-16ef-4a25-a59f-335837a9f2c7
Boniface, Michael
f30bfd7d-20ed-451b-b405-34e3e22fdfba
Burns, Daniel
40b9dc88-a54a-4365-b747-4456d9203146
Duckworth, Chris
992c216c-8f66-48a8-8de6-2f04b4f736e6
Duruiheoma, Franklin
bd050a22-85bc-49ae-8d39-b97e0f08453b
Armitage, Htwe
f20a9e2d-1b62-4f17-8e9c-bfd6a0e0589f
Ratcliffe, Naomi
f10be2f5-bcd9-49ab-9967-ae421f977b7d
Duffy, John
c0e4f8e0-72e4-4aa8-83d2-74cec233179c
O’Keeffe, Caroline
879cfd52-02e7-406e-b974-ca9bd5de07f2
Inada-Kim, Matt
eaac8cc7-16ef-4a25-a59f-335837a9f2c7

Boniface, Michael, Burns, Daniel, Duckworth, Chris, Duruiheoma, Franklin, Armitage, Htwe, Ratcliffe, Naomi, Duffy, John, O’Keeffe, Caroline and Inada-Kim, Matt (2021) COVID Oximetry @home: evaluation of patient outcomes. medRxiv. (doi:10.1101/2021.05.29.21257899).

Record type: Article

Abstract

Background COVID-19 has placed unprecedented demands on hospitals. A clinical service, COVID Oximetry @home (CO@h) was launched in November 2020 to support remote monitoring of COVID-19 patients in the community. Remote monitoring through CO@h aims to identify early patient deterioration and provide timely escalation for cases of silent hypoxia, while reducing the burden on secondary care. Methods We conducted a retrospective service evaluation of COVID-19 patients onboarded to CO@h from November 2020 to March 2021 in the North Hampshire (UK) community led service (a collaboration of 15 GP practices, covering a population of 230,000 people). We have compared outcomes for patients admitted to Basingstoke & North Hampshire Hospital who were CO@h patients (COVID-19 patients with monitoring of SpO2 (n=137)), with non CO@h patients (those directly admitted without being monitored by CO@h (n=633)). Odds Ratio analysis was performed to contrast the likelihood of patient outcomes resulting in 30 day mortality, ICU admission and length of stay greater than 3, 7, 14, and 28 days. Results Hospital length of stay was reduced by an average of 6.3 days for CO@h patients (6.9 95% CI [5.6 - 8.1]) in comparison to Non-CO@h (13.2 95% CI [12.2 - 14.1]). The most significant odds ratio effect was on mortality (0.23 95%CI [0.11 - 0.49]), followed by length of stay > 14 days (OR 0.23 95%CI [0.13 - 0.42]), length of stay > 28 days (OR 0.23 95%CI [0.08 - 0.65]), length of stay > 7 days (OR 0.35 95%CI [0.24 - 0.52]), and length of stay > 3 days (OR 0.52 95%CI [0.35 - 0.78]). Mortality and length of stay outcomes were statistically significant. Only 5/137 (3.6%) where admitted to ICU compared with 52/633 (8.2%) for Non-CO@h. Conclusions CO@h has demonstrated considerably improved patient outcomes reducing the odds of longer length hospital stays and mortality.

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Published date: 2 June 2021

Identifiers

Local EPrints ID: 450335
URI: http://eprints.soton.ac.uk/id/eprint/450335
PURE UUID: 0127b942-1ac7-4cf3-8e67-c5b416b5513e
ORCID for Michael Boniface: ORCID iD orcid.org/0000-0002-9281-6095
ORCID for Daniel Burns: ORCID iD orcid.org/0000-0001-6976-1068

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Date deposited: 23 Jul 2021 16:58
Last modified: 24 Jul 2021 01:52

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Contributors

Author: Daniel Burns ORCID iD
Author: Chris Duckworth
Author: Franklin Duruiheoma
Author: Htwe Armitage
Author: Naomi Ratcliffe
Author: John Duffy
Author: Caroline O’Keeffe
Author: Matt Inada-Kim

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