Patient characteristics and admitting vital signs associated with coronavirus disease 2019 (COVID-19)-related mortality among patients admitted with noncritical illness

To determine risk factors for mortality among COVID-19 patients admitted to a system of community hospitals in the United States. Retrospective analysis of patient data collected from the routine care of COVID-19 patients. System of >180 acute-care facilities in the United States. All admitted pa...

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Bibliographic Details
Published in:Infection Control & Hospital Epidemiology 2021-04, Vol.42 (4), p.399-405
Main Authors: Sands, Kenneth E, Wenzel, Richard P, McLean, Laura E, Korwek, Kimberly M, Roach, Jonathon D, Miller, Karla M, Poland, Russell E, Burgess, L Hayley, Jackson, Edmund S, Perlin, Jonathan B
Format: Article
Language:English
Subjects:
Age Factors
Aged
Aged, 80 and over
Coronaviruses
COVID-19
COVID-19 - mortality
COVID-19 - pathology
Demographics
Female
Humans
Logistic Models
Male
Middle Aged
Mortality
Nursing
Original
Oxygen - blood
Patient Admission - statistics & numerical data
Retrospective Studies
Risk Factors
United States - epidemiology
Ventilators
Vital Signs
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Summary:To determine risk factors for mortality among COVID-19 patients admitted to a system of community hospitals in the United States. Retrospective analysis of patient data collected from the routine care of COVID-19 patients. System of >180 acute-care facilities in the United States. All admitted patients with positive identification of COVID-19 and a documented discharge as of May 12, 2020. Determination of demographic characteristics, vital signs at admission, patient comorbidities and recorded discharge disposition in this population to construct a logistic regression estimating the odds of mortality, particular for those patients characterized as not being critically ill at admission. In total, 6,180 COVID-19+ patients were identified as of May 12, 2020. Most COVID-19+ patients (4,808, 77.8%) were admitted directly to a medical-surgical unit with no documented critical care or mechanical ventilation within 8 hours of admission. After adjusting for demographic characteristics, comorbidities, and vital signs at admission in this subgroup, the largest driver of the odds of mortality was patient age (OR, 1.07; 95% CI, 1.06-1.08; P < .001). Decreased oxygen saturation at admission was associated with increased odds of mortality (OR, 1.09; 95% CI, 1.06-1.12; P < .001) as was diabetes (OR, 1.57; 95% CI, 1.21-2.03; P < .001). The identification of factors observable at admission that are associated with mortality in COVID-19 patients who are initially admitted to non-critical care units may help care providers, hospital epidemiologists, and hospital safety experts better plan for the care of these patients.
ISSN:0899-823X
1559-6834
DOI:10.1017/ice.2020.461