Interhospital Transfer Versus Other Modes of Admission of Patients With Covid-19 at the University Hospital Andohatapenaka: “a Retrospective Cohort Study”

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.