Characteristics and outcomes of hospital admissions for COVID-19 and influenza in the Toronto area.
Characteristics and outcomes of hospital admissions for COVID-19 and influenza in the Toronto area.
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DOI：
10.1503/cmaj.202795
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发表时间：
2021-03-22
期刊：
影响因子：
--
通讯作者：
Razak F
中科院分区：
文献类型：
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作者：
Verma AA;Hora T;Jung HY;Fralick M;Malecki SL;Lapointe-Shaw L;Weinerman A;Tang T;Kwan JL;Liu JJ;Rawal S;Chan TCY;Cheung AM;Rosella LC;Ghassemi M;Herridge M;Mamdani M;Razak F
加拿大因 2019 年冠状病毒病 (COVID-19) 入院的患者特征、临床护理、资源使用和结果尚未得到充分描述。我们描述了 2019 年 11 月 1 日至 2020 年 6 月 30 日期间在多伦多和安大略省密西沙加的 7 家医院从住院医疗服务和内外科重症监护病房 (ICU) 出院的所有患有 COVID-19 或流感的成年人。我们使用多变量回归模型比较患者的结果，控制患者的社会人口因素和合并症水平。我们验证了 7 个外部开发的风险评分的准确性，以预测 COVID-19 患者的死亡率。共有 1027 例因 COVID-19 入院（中位年龄 65 岁，59.1% 男性），783 例因流感入院（中位年龄 68 岁，50.8% 男性）。 50 岁以下的患者占所有因 COVID-19 入院的患者的 21.2%，占 ICU 入院患者的 24.0%。与流感相比，COVID-19患者的院内死亡率（未经调整的19.9% vs. 6.1%，调整后的相对风险[RR] 3.46，95%置信区间[CI] 2.56–4.68）、ICU使用率（未经调整的26.4% vs. 18.0%，调整后的RR 1.50，95% CI 1.25–1.80）显着更高住院时间（未经调整的中位数 8.7 天 vs. 4.8 天，调整后的比率 1.45，95% CI 1.25-1.69）。 30 天再入院率没有显着差异（未调整 9.3% vs. 9.6%，调整后 RR 0.98，95% CI 0.70–1.39）。用于预测院内死亡率的基于三点的风险评分显示出良好的区分度（受试者工作特征曲线下面积 [AUC] 范围为 0.72 至 0.81）和校准。在第一波大流行期间，与流感相比，因 COVID-19 入院的死亡率、ICU 使用率和住院时间显着增加。简单的风险评分可以非常准确地预测 COVID-19 患者的院内死亡率。
Patient characteristics, clinical care, resource use and outcomes associated with admission to hospital for coronavirus disease 2019 (COVID-19) in Canada are not well described. We described all adults with COVID-19 or influenza discharged from inpatient medical services and medical–surgical intensive care units (ICUs) between Nov. 1, 2019, and June 30, 2020, at 7 hospitals in Toronto and Mississauga, Ontario. We compared patient outcomes using multivariable regression models, controlling for patient sociodemographic factors and comorbidity level. We validated the accuracy of 7 externally developed risk scores to predict mortality among patients with COVID-19. There were 1027 hospital admissions with COVID-19 (median age 65 yr, 59.1% male) and 783 with influenza (median age 68 yr, 50.8% male). Patients younger than 50 years accounted for 21.2% of all admissions for COVID-19 and 24.0% of ICU admissions. Compared with influenza, patients with COVID-19 had significantly greater in-hospital mortality (unadjusted 19.9% v. 6.1%, adjusted relative risk [RR] 3.46, 95% confidence interval [CI] 2.56–4.68), ICU use (unadjusted 26.4% v. 18.0%, adjusted RR 1.50, 95% CI 1.25–1.80) and hospital length of stay (unadjusted median 8.7 d v. 4.8 d, adjusted rate ratio 1.45, 95% CI 1.25–1.69). Thirty-day readmission was not significantly different (unadjusted 9.3% v. 9.6%, adjusted RR 0.98, 95% CI 0.70–1.39). Three points-based risk scores for predicting in-hospital mortality showed good discrimination (area under the receiver operating characteristic curve [AUC] ranging from 0.72 to 0.81) and calibration. During the first wave of the pandemic, admission to hospital for COVID-19 was associated with significantly greater mortality, ICU use and hospital length of stay than influenza. Simple risk scores can predict in-hospital mortality in patients with COVID-19 with good accuracy.
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DOI：
10.1056/nejmoa2022926
发表时间：
2020-11-19
期刊：
The New England journal of medicine
影响因子：
--
作者：
RECOVERY Collaborative Group;Horby P;Mafham M;Linsell L;Bell JL;Staplin N;Emberson JR;Wiselka M;Ustianowski A;Elmahi E;Prudon B;Whitehouse T;Felton T;Williams J;Faccenda J;Underwood J;Baillie JK;Chappell LC;Faust SN;Jaki T;Jeffery K;Lim WS;Montgomery A;Rowan K;Tarning J;Watson JA;White NJ;Juszczak E;Haynes R;Landray MJ
通讯作者：
Landray MJ
影响因子：
13.8
作者：
Fisman, David N.;Bogoch, Isaac;Tuite, Ashleigh R.
通讯作者：
Tuite, Ashleigh R.
影响因子：
3.7
作者：
Fortis, Spyridon;O'Shea, Amy M. J.;Sarrazin, Mary Vaughan
通讯作者：
Sarrazin, Mary Vaughan
DOI：
10.15585/mmwr.mm6945e2
发表时间：
2020-11-13
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Lavery AM;Preston LE;Ko JY;Chevinsky JR;DeSisto CL;Pennington AF;Kompaniyets L;Datta SD;Click ES;Golden T;Goodman AB;Mac Kenzie WR;Boehmer TK;Gundlapalli AV
通讯作者：
Gundlapalli AV
利用机器学习早期预测重症 COVID-19 患者的死亡风险
影响因子：
7.7
作者：
Hu, Chuanyu;Liu, Zhenqiu;Chen, Xingdong
通讯作者：
Chen, Xingdong