Demographic, Clinical, Hospital Factors Tied to COVID-19 Death
MONDAY, July 20, 2020 -- For COVID-19 patients in the intensive care unit (ICU), demographic, clinical, and hospital-level risk factors are associated with death, according to a study published online July 15 in JAMA Internal Medicine.
Shruti Gupta, M.D., M.P.H., from Brigham and Women's Hospital in Boston, and colleagues examined factors associated with death and interhospital variation in treatment and outcomes in a multicenter study involving 2,215 adults with COVID-19 admitted to ICUs at 65 hospitals.
The researchers found that 39.5, 54.3, and 6.2 percent of patients had died, were discharged, and remained hospitalized, respectively, at the end of study follow-up. Independent associations with death were seen for older age (≥80 versus <40 years: odds ratio, 11.15); male sex (odds ratio, 1.50); higher body mass index (≥40 versus <25 kg/m²: odds ratio, 1.51); coronary artery disease (odds ratio, 1.47); active cancer (odds ratio, 2.15); and presence of hypoxemia (odds ratio, 2.94), liver dysfunction (odds ratio, 2.61), or kidney dysfunction (odds ratio, 2.43). The risk for death was also higher for patients admitted to hospitals with fewer ICU beds (<50 versus ≥100 ICU beds: odds ratio, 3.28). There was considerable variation between hospitals in the risk-adjusted proportion of patients who died (range, 6.6 to 80.8 percent) and in the percentage of patients receiving treatments and supportive therapies.
"Future research should examine the patients with COVID-19 at greatest risk of adverse outcomes and seek to identify medications or supportive therapies that improve their outcomes," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
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Posted: July 2020