Abstract
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.
Highlights
Geographically diverse composite of hospitalized patients with COVID-19 across the United States, we have identified patient characteristics and vital signs at presentation that are associated with mortality
As of May 12, 2020, we have identified 6,180 COVID-19þ patients discharged from facilities affiliated with a large healthcare system in the United States
Among COVID-19þ patient encounters admitted with noncritical illness, we detected increased odds of mortality associated with increased age, diabetes, and lower oxygen saturation at admission
Summary
The purpose of this study was to describe the demographic characteristics and vital signs on presentation of a more representative sample of COVID-19þ patients in the United States and to determine subsets of these by illness severity at admission. This analysis provides information about potential predictors of COVID-19 mortality from a national data set among patients who present with noncritical illness at admission that can be used by clinicians, hospital epidemiologists, and hospital safety experts to better target resources and improve patient care.
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