Variation in COVID-19 Mortality Across 117 US Hospitals in High- and Low-Burden Settings
Variation in COVID-19 Mortality Across 117 US Hospitals in High- and Low-Burden Settings
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DOI：
10.12788/jhm.3612
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发表时间：
2021-04-01
影响因子：
2.6
通讯作者：
Smith, Alexander K.
中科院分区：
文献类型：
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作者：
Block, Brian L.;Martin, Thomas M.;Smith, Alexander K.
一些医院面临着新冠肺炎患者激增的问题，而另一些医院则没有。我们评估了COVID-19负担（2020年4月收治的COVID-19患者人数除以医院认证的床位数）是否与大样本美国医院的死亡率相关。我们的研究人群包括117家医院的14，226名COVID-19患者（中位年龄66岁，45.2%为女性），其中20.9%在5周随访时死亡。在医院一级，观察到的死亡率范围为0%至44.4%。校正年龄、性别和合并症后，与所有其他五分位数相比，负担最高五分位数的院内死亡校正比值比为1.46（95%CI，1.07-2.00）。尽管如此，即使在COVID-19负担水平相似的医院之间，以及在调整年龄，性别和合并症后，结果也存在很大的差异。(C)2021医院医学学会
Some hospitals have faced a surge of patients with COVID-19, while others have not. We assessed whether COVID-19 burden (number of patients with COVID-19 admitted during April 2020 divided by hospital certified bed count) was associated with mortality in a large sample of US hospitals. Our study population included 14,226 patients with COVID-19 (median age 66 years, 45.2% women) at 117 hospitals, of whom 20.9% had died at 5 weeks of follow-up. At the hospital level, the observed mortality ranged from 0% to 44.4%. After adjustment for age, sex, and comorbidities, the adjusted odds ratio for in-hospital death in the highest quintile of burden was 1.46 (95% CI, 1.07-2.00) compared to all other quintiles. Still, there was large variability in outcomes, even among hospitals with a similar level of COVID-19 burden and after adjusting for age, sex, and comorbidities. (C) 2021 Society of Hospital Medicine