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Outcomes of Hospitalized COVID-19 Patients by Risk Factors: Results from a United States Hospital Claims Database
Peter J Mallow1, Kathy W Belk2, Michael Topmiller3
1Xavier University, Department of Health Services Administration, Cincinnati, OH.
Insights
The number of Centers for Disease Control and Prevention (CDC) risk factors significantly increases COVID-19 in-hospital mortality and resource utilization. Identifying these risk factors aids in patient stratification for closer monitoring and intensive treatment.
Area of Science:
- Infectious Diseases
- Epidemiology
- Critical Care Medicine
Background:
- COVID-19 presents a significant public health challenge.
- Understanding risk factors is crucial for patient management and resource allocation.
Purpose of the Study:
- To quantify the association between the number of Centers for Disease Control and Prevention (CDC) risk factors and in-hospital mortality.
- To assess the impact of CDC risk factors on hospital length of stay (LOS), intensive care unit (ICU) bed utilization, and ICU LOS.
Main Methods:
- Retrospective cohort study of COVID-19 hospitalizations (March 15, 2020 - April 30, 2020).
- Data from 276 acute care hospitals across the United States.
- Multivariable regression modeling to analyze outcomes based on the number of CDC risk factors.
Main Results:
- Increased number of CDC risk factors correlated with significantly higher in-hospital mortality.
- Patients with one, two, or three+ risk factors had odds ratios (OR) for mortality of 2.08, 2.63, and 3.49, respectively.
- CDC risk factors were associated with increased ICU utilization, longer ICU LOS, and longer hospital LOS.
Conclusions:
- Quantifying CDC risk factors is vital for improving risk stratification in COVID-19 patients.
- Early identification of patients with multiple risk factors can guide closer monitoring and more intensive treatment strategies.
Background/Objective:
The primary objective was to quantify the role of the number of Centers of Disease Control and Prevention (CDC) risk factors on in-hospital mortality. The secondary objective was to assess the associated hospital length of stay (LOS), intensive care unit (ICU) bed utilization, and ICU LOS with the number of CDC risk factors.
Methods:
A retrospective cohort study consisting of all hospitalizations with a confirmed COVID-19 diagnosis discharged between March 15, 2020 and April 30, 2020 was conducted. Data was obtained from 276 acute care hospitals across the United States. Cohorts were identified based upon the number of the CDC COVID-19 risk factors. Multivariable regression modeling was performed to assess outcomes and utilization. The odds ratio (OR) and incidence rate ratio (IRR) were reported.
Results:
Compared with patients with no CDC risk factors, patients with risk factors were significantly more likely to die during the hospitalization: One risk factor (OR 2.08, 95% CI, 1.60-2.70; P < 0.001), two risk factors (OR 2.63, 95% CI, 2.00-3.47; P < 0.001), and three or more risk factors (OR 3.49, 95% CI, 2.53-4.80; P < 0.001). The presence of CDC risk factors was associated with increased ICU utilization, longer ICU LOS, and longer hospital LOS compared to those with no risk factors. Patients with hypertension (OR 0.77, 95% CI, 0.70-0.86; P < 0.001) and those administered statins were less likely to die (OR 0.54, 95% CI, 0.49-0.60; P < 0.001).
Conclusions:
Quantifying the role of CDC risk factors upon admission may improve risk stratification and identification of patients who may require closer monitoring and more intensive treatment.
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