Changes in COVID-19 in-hospital mortality in hospitalised adults in England over the first seven months of the pandemic: An observational study using administrative data.
Changes in COVID-19 in-hospital mortality in hospitalised adults in England over the first seven months of the pandemic: An observational study using administrative data.
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2019冠状病毒病大流行前七个月英格兰住院成人住院死亡率的变化：一项使用行政数据的观察性研究。
DOI：
10.1016/j.lanepe.2021.100104
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Briggs TWR
中科院分区：
文献类型：
--
作者：
Gray WK;Navaratnam AV;Day J;Wendon J;Briggs TWR
我们团队之前的研究确定了2020年3月至5月期间英格兰确诊COVID-19患者住院死亡率的相关因素。本文的目的是调查人口统计学和共病的变化作用，特别关注种族，作为长期住院死亡率的风险因素。这是一项使用医院事件统计管理数据集的回顾性观察性研究。纳入了英格兰所有年龄≥ 18岁、诊断为COVID-19且在2020年3月1日至9月30日期间完成住院（活着出院或死亡）的患者。院内死亡率是主要关注的结局。采用多水平logistic回归模型对住院死亡率与协变量（年龄、性别、贫困、种族、出院日期和一些合并症）之间的关系进行校正。与3月至5月的患者（n = 93，379）相比，6月至9月的患者（n = 24，059）更年轻，更可能是女性和亚裔，但黑人的可能性较小。经协变量调整后的住院死亡率从3月份的33-34%下降到9月份的11-12%。与3月至5月期间相比，孟加拉国、印度和其他亚洲种族患者在6月至9月期间的相对死亡几率较低（与白色种族患者相比）。对于巴基斯坦患者，在同一时间段内，住院死亡率的下降幅度较小，死亡的相对比值略有增加（比值比（95%置信区间））分别为1.24（1.10至1.40）和1.35（1.08至1.69）。从3 - 5月到6 - 9月，诊断为转移性癌的患者的相对死亡率增加（1.90（1.73至2.08）vs 3.01（2.55 - 3.54）），但男性患者降低（1.44（1.39至1.49）vs 1.27（1.17至1.38））和肥胖患者（1.42（1.34至1.52）vs 0.97（0.83至1.14））和无并发症的糖尿病（1.14（1.10至1.19）vs 0.95（0.87至1.05））。确诊为COVID-19的患者的住院死亡率大幅下降，有证据表明自疫情开始以来，一些协变量的相对重要性发生了变化。随着病毒新变种的出现、疫苗接种计划的推出和医院压力的波动，应继续跟踪这些模式。一个也没有。
Previous research by our team identified factors associated with in-hospital mortality in patients with a diagnosis of COVID-19 in England between March and May 2020. The aim of the current paper was to investigate the changing role of demographics and co-morbidity, with a particular focus on ethnicity, as risk factors for in-hospital mortality over an extended period. This was a retrospective observational study using the Hospital Episode Statistics administrative dataset. All patients aged ≥ 18 years in England with a diagnosis of COVID-19 who had a hospital stay that was completed (discharged alive or died) between 1st March and 30th September 2020 were included. In-hospital mortality was the primary outcome of interest. Multilevel logistic regression was used to model the relationship between in-hospital mortality with adjustment for the covariates: age, sex, deprivation, ethnicity, date of discharge and a number of comorbidities. Compared to patients in March-May (n = 93,379), patients in June-September (n = 24,059) were younger, more likely to be female and of Asian ethnicity, but less likely to be of Black ethnicity. In-hospital mortality rates, adjusted for covariates, declined from 33–34% in March to 11–12% in September. Compared to the March-May period, Bangladeshi, Indian and Other Asian ethnicity patients had a lower relative odds of death (compared to White ethnicity patients) during June-September. For Pakistani patients, the decline in-hospital mortality rates was more modest across the same time periods with the relative odds of death increasing slightly (odds ratio (95% confidence interval)) 1.24 (1.10 to 1.40) and 1.35 (1.08 to 1.69) respectively. From March-May to June-September the relative odds of death in patients with a diagnosis of metastatic carcinoma increased (1.90 (1.73 to 2.08) vs 3.01 (2.55 to 3.54)) but decreased for male patients (1.44 (1.39 to 1.49) vs 1.27 (1.17 to 1.38)) and patients with obesity (1.42 (1.34 to 1.52) vs 0.97 (0.83 to 1.14)) and diabetes without complications (1.14 (1.10 to 1.19) vs 0.95 (0.87 to 1.05)). In-hospital mortality rates for patients with a diagnosis of COVID-19 have fallen substantially and there is evidence that the relative importance of some covariates has changed since the start of the pandemic. These patterns should continue to be tracked as new variants of the virus emerge, vaccination programmes are rolled out and hospital pressures fluctuate. None.
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DOI：
10.1016/s0140-6736(20)32661-1
发表时间：
2021-01-09
期刊：
Lancet (London, England)
影响因子：
--
作者：
Voysey M;Clemens SAC;Madhi SA;Weckx LY;Folegatti PM;Aley PK;Angus B;Baillie VL;Barnabas SL;Bhorat QE;Bibi S;Briner C;Cicconi P;Collins AM;Colin-Jones R;Cutland CL;Darton TC;Dheda K;Duncan CJA;Emary KRW;Ewer KJ;Fairlie L;Faust SN;Feng S;Ferreira DM;Finn A;Goodman AL;Green CM;Green CA;Heath PT;Hill C;Hill H;Hirsch I;Hodgson SHC;Izu A;Jackson S;Jenkin D;Joe CCD;Kerridge S;Koen A;Kwatra G;Lazarus R;Lawrie AM;Lelliott A;Libri V;Lillie PJ;Mallory R;Mendes AVA;Milan EP;Minassian AM;McGregor A;Morrison H;Mujadidi YF;Nana A;O'Reilly PJ;Padayachee SD;Pittella A;Plested E;Pollock KM;Ramasamy MN;Rhead S;Schwarzbold AV;Singh N;Smith A;Song R;Snape MD;Sprinz E;Sutherland RK;Tarrant R;Thomson EC;Török ME;Toshner M;Turner DPJ;Vekemans J;Villafana TL;Watson MEE;Williams CJ;Douglas AD;Hill AVS;Lambe T;Gilbert SC;Pollard AJ;Oxford COVID Vaccine Trial Group
通讯作者：
Oxford COVID Vaccine Trial Group
DOI：
10.1016/s2213-2600(20)30579-8
发表时间：
2021-04
期刊：
The Lancet. Respiratory medicine
影响因子：
--
作者：
Navaratnam AV;Gray WK;Day J;Wendon J;Briggs TWR
通讯作者：
Briggs TWR
影响因子：
16.2
作者：
Dennis JM;Mateen BA;Sonabend R;Thomas NJ;Patel KA;Hattersley AT;Denaxas S;McGovern AP;Vollmer SJ
通讯作者：
Vollmer SJ
影响因子：
44.5
作者：
Holman, Naomi;Knighton, Peter;Valabhji, Jonathan
通讯作者：
Valabhji, Jonathan
影响因子：
8.8
作者：
Dennis JM;McGovern AP;Vollmer SJ;Mateen BA
通讯作者：
Mateen BA