Hospital Length of Stay for Patients with Severe COVID-19: Implications for Remdesivir's Value.
Hospital Length of Stay for Patients with Severe COVID-19: Implications for Remdesivir's Value.
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DOI：
10.1007/s41669-020-00243-6
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Baldwin MR
中科院分区：
文献类型：
--
作者：
Anderson MR;Bach PB;Baldwin MR
2方法我们的研究队列由2020年3月9日至4月23日期间在纽约长老会哥伦比亚大学欧文医学中心和艾伦社区医院急诊科（艾德）连续住院的≥ 18岁重度COVID-19成人组成，随访至2020年6月10日。数据抽象方法以前已经发表[7，8]。我们根据瑞德西韦试验和FDA标准定义了重度COVID-19：在室内空气中的初始氧饱和度≤ 94%或在艾德出现后24小时内使用任何辅助供氧[2，9]。LOS从就诊到死亡或出院进行测量。3结果总共有1643名成年人因严重COVID-19入院，排除了21名（1%）在9天内出院到另一家医院的人。中位年龄为67岁（四分位距56-78），大多数为西班牙裔或黑人，有一种或多种合并症，12%在24小时内需要机械通气，中位LOS为7（3-14）天，住院28天死亡率为26%。总共有586例患者（36%）的LOS为1-4天，384例患者（23%）的LOS为5-8天，673例患者（41%）住院≥ 9天（表1）。当排除住院期间死亡的患者时，分布相似（表1）。LOS为1-4或5-8天的患者中，大多数年龄≥ 60岁（分别为67%和70%;图1）。
2 MethodsOur study cohort consisted of adults aged≥ 18 years with severe COVID-19 consecutively hospitalized from the emergency department (ED) at New York-Presbyterian Columbia University Irving Medical Center and the Allen community hospital between March 9 and April 23, 2020, with follow-up through June 10, 2020. Data abstraction methods have been published previously [7, 8]. We defined severe COVID-19 based on remdesivir trial and FDA criteria: an initial oxygen saturation≤ 94% on room air or the use of any supplemental oxygen within 24 h of ED presentation [2, 9]. LOS was measured from presentation to death or hospital discharge.3 ResultsIn total, 1643 adults were admitted with severe COVID-19, after excluding 21 (1%) who were discharged in< 9 days to another hospital. The median age was 67 years (interquartile range 56–78), a majority were Hispanic or Black and had one or more comorbidity, 12% required mechanical ventilation within 24 h, median LOS was 7 (3–14) days, and in-hospital 28-day mortality was 26%. In total, 586 patients (36%) had a LOS of 1–4 days, 384 (23%) had a LOS of 5–8 days, and 673 (41%) were hospitalized for≥ 9 days (Table 1). The distribution was similar when patients who died during their hospital stay were excluded (Table 1). The majority of those with a LOS of 1–4 or 5–8 days were aged≥ 60 years (67% and 70%, respectively; Fig. 1).
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