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Published on: January 8, 2020
Effect of mortality from COVID-19 on inpatient outcomes
Matthew C Phillips1, Laura Sarff1, Josh Banerjee1
1Los Angeles County + University of Southern California (LAC + USC) Medical Center, Los Angeles, California, USA.
Insights
Hospital mortality from coronavirus disease 2019 (COVID-19) declined to under 10% by June 2020. However, overall inpatient mortality has increased, particularly for elderly patients and those needing intubation.
Area of Science:
- Healthcare Analytics
- Epidemiology
- Critical Care Medicine
Background:
- Initial encounters with coronavirus disease 2019 (COVID-19) presented limited therapeutic options, leading to high mortality rates.
- By summer 2020, national trends and single-center studies indicated a decline in COVID-19-specific patient mortality.
Purpose of the Study:
- To assess the impact of COVID-19 on overall hospital-based mortality using a large, multi-center dataset.
- To analyze trends in inpatient mortality from January 2017 through December 2020, encompassing the initial phase of the pandemic.
Main Methods:
- Utilized the Vizient Clinical Data Base, analyzing over 32 million hospital admissions from approximately 600 hospitals, including 130 academic medical centers.
- Examined outcomes data from January 2017 to December 2020 to track mortality trends before and during the COVID-19 pandemic.
Main Results:
- Mortality from COVID-19 decreased significantly to below 10% nationally by June 2020 and remained stable.
- Despite the decline in COVID-19-specific deaths, overall inpatient, all-cause mortality increased post-pandemic onset.
- Inpatient mortality saw a marked rise in elderly patients and those requiring intubation for respiratory failure.
Conclusions:
- While COVID-19 mortality improved, its overall contribution has elevated hospital mortality rates, especially for critically ill patients requiring mechanical ventilation.
- The pandemic's broader impact on hospital care necessitates continued monitoring of inpatient mortality trends beyond COVID-19-specific outcomes.
Abstract:
When hospitals first encountered coronavirus disease 2019 (COVID-19), there was a dearth of therapeutic options and nearly 1 in 3 patients died from the disease. By the summer of 2020, as deaths from the disease declined nationally, multiple single-center studies began to report declining mortality of patients with COVID-19. To evaluate the effect of COVID-19 on hospital-based mortality, we searched the Vizient Clinical Data Base for outcomes data from approximately 600 participating hospitals, including 130 academic medical centers, from January 2017 through December 2020. More than 32 million hospital admissions were included in the analysis. After an initial spike, mortality from COVID-19 declined in all regions of the country to under 10% by June 2020 and remained constant for the remainder of the year. Despite this, inpatient, all-cause mortality has increased since the beginning of the pandemic, even those without respiratory failure. Inpatient mortality has particularly increased in elderly patients and in those requiring intubation for respiratory failure. Since June 2020, COVID-19 kills one in every 10 patients admitted to the hospital with this diagnosis. The addition of this new disease has raised overall hospital mortality especially those who require intubation for respiratory failure.
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