Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US
Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US
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DOI：
10.1001/jamainternmed.2020.3596
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发表时间：
2020-11-01
影响因子：
39
通讯作者：
Leaf, David E.
中科院分区：
文献类型：
--
作者：
Gupta, Shruti;Hayek, Salim S.;Leaf, David E.
美国目前是2019年冠状病毒病的中心（COVID-19）大流行，但很少有关于COVID-19危重病患者特征、治疗和结局的国家数据。为了评估与死亡相关的因素，并检查COVID-19患者治疗和结局的医院间差异。设计，背景，和参与者这项多中心队列研究评估了2215名实验室确诊的COVID-19成年人，他们于2020年3月4日至4月4日在美国65家医院的重症监护室（ICU）住院。主要结果和指标主要结果是28天的住院死亡率。多水平逻辑回归被用来评估与死亡相关的因素，并检查治疗和outcome.Results医院间的变化，共2215例患者（平均[SD]年龄，60.5 [14.5]岁，1436 [64.8%]男性，1738 [78.5%]至少有1个慢性合并症）被列入研究。在ICU入院后28天，784例患者（35.4%）死亡，824例（37.2%）出院，607例（27.4%）仍在住院。在研究随访结束时（中位数，16天;四分位距，8-28天），875例患者（39.5%）死亡，1203例（54.3%）出院，137例（6.2%）仍住院。与死亡独立相关的因素包括老年（≥ 80 vs = 40 vs
IMPORTANCE The US is currently an epicenter of the coronavirus disease 2019 (COVID-19) pandemic, yet few national data are available on patient characteristics, treatment, and outcomes of critical illness from COVID-19.OBJECTIVES To assess factors associated with death and to examine interhospital variation in treatment and outcomes for patients with COVID-19.DESIGN, SETTING, AND PARTICIPANTS This multicenter cohort study assessed 2215 adults with laboratory-confirmed COVID-19 who were admitted to intensive care units (ICUs) at 65 hospitals across the US from March 4 to April 4, 2020.EXPOSURES Patient-level data, including demographics, comorbidities, and organ dysfunction, and hospital characteristics, including number of ICU beds.MAIN OUTCOMES AND MEASURES The primary outcomewas 28-day in-hospital mortality. Multilevel logistic regression was used to evaluate factors associated with death and to examine interhospital variation in treatment and outcomes.RESULTS A total of 2215 patients (mean [SD] age, 60.5 [14.5] years; 1436 [64.8%] male; 1738 [78.5%] with at least 1 chronic comorbidity) were included in the study. At 28 days after ICU admission, 784 patients (35.4%) had died, 824 (37.2%) were discharged, and 607 (27.4%) remained hospitalized. At the end of study follow-up (median, 16 days; interquartile range, 8-28 days), 875 patients (39.5%) had died, 1203 (54.3%) were discharged, and 137 (6.2%) remained hospitalized. Factors independently associated with death included older age (>= 80 vs = 40 vs