Factors associated with COVID-19-related death using OpenSAFELY.
Factors associated with COVID-19-related death using OpenSAFELY.
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DOI：
10.1038/s41586-020-2521-4
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发表时间：
2020-08
期刊：
影响因子：
64.8
通讯作者：
Goldacre B
中科院分区：
文献类型：
--
作者：
Williamson EJ;Walker AJ;Bhaskaran K;Bacon S;Bates C;Morton CE;Curtis HJ;Mehrkar A;Evans D;Inglesby P;Cockburn J;McDonald HI;MacKenna B;Tomlinson L;Douglas IJ;Rentsch CT;Mathur R;Wong AYS;Grieve R;Harrison D;Forbes H;Schultze A;Croker R;Parry J;Hester F;Harper S;Perera R;Evans SJW;Smeeth L;Goldacre B
COVID-19迅速影响了全球的死亡率。了解谁最有可能发生严重后果的紧迫性是前所未有的，需要新的方法来及时分析大型数据集。我们代表英国NHS创建了OpenSAFELY：一个安全的健康分析平台，覆盖英国40%的患者，将患者数据保存在一家主要初级保健电子健康记录供应商的现有数据中心内。17，278，392名成年人的初级保健记录与10，926例COVID-19相关死亡有着千丝万缕的联系。COVID-19相关死亡与以下因素相关：男性（风险比1.59，95%CI 1.53-1.65）;老年和贫困（两者都有很强的梯度）;糖尿病;严重哮喘;以及各种其他医疗状况。与白色种族的人相比，黑人和南亚人的风险更高，即使在调整其他因素后（HR分别为1.48，1.29-1.69和1.45，1.32-1.58）。我们在迄今为止任何国家进行的最大规模队列研究中量化了COVID-19相关死亡的一系列临床风险因素。OpenSAFELY正在迅速增加更多患者的记录;我们将定期更新和扩展结果。
COVID-19 has rapidly impacted on mortality worldwide. There is unprecedented urgency to understand who is most at risk of severe outcomes, requiring new approaches for timely analysis of large datasets. Working on behalf of NHS England we created OpenSAFELY: a secure health analytics platform covering 40% of all patients in England, holding patient data within the existing data centre of a major primary care electronic health records vendor. Primary care records of 17,278,392 adults were pseudonymously linked to 10,926 COVID-19 related deaths. COVID-19 related death was associated with: being male (hazard ratio 1.59, 95%CI 1.53-1.65); older age and deprivation (both with a strong gradient); diabetes; severe asthma; and various other medical conditions. Compared to people with white ethnicity, black and South Asian people were at higher risk even after adjustment for other factors (HR 1.48, 1.29-1.69 and 1.45, 1.32-1.58 respectively). We have quantified a range of clinical risk factors for COVID-19 related death in the largest cohort study conducted by any country to date. OpenSAFELY is rapidly adding further patients’ records; we will update and extend results regularly.
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