Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US
dc.contributor.author | Gupta, Shruti | |
dc.contributor.author | Hayek, Salim S. | |
dc.contributor.author | Wang, Wei | |
dc.contributor.author | Chan, Lili | |
dc.contributor.author | Mathews, Kusum S. | |
dc.contributor.author | Melamed, Michal L. | |
dc.contributor.author | Brenner, Samantha K. | |
dc.contributor.author | Leonberg-Yoo, Amanda | |
dc.contributor.author | Schenck, Edward J. | |
dc.contributor.author | Radbel, Jared | |
dc.contributor.author | Reiser, Jochen | |
dc.contributor.author | Bansal, Anip | |
dc.contributor.author | Srivastava, Anand | |
dc.contributor.author | Zhou, Yan | |
dc.contributor.author | Sutherland, Anne | |
dc.contributor.author | Green, Adam | |
dc.contributor.author | Shehata, Alexandre M. | |
dc.contributor.author | Goyal, Nitender | |
dc.contributor.author | Vijayan, Anitha | |
dc.contributor.author | Velez, Juan Carlos Q. | |
dc.contributor.author | Shaefi, Shahzad | |
dc.contributor.author | Parikh, Chirag R. | |
dc.contributor.author | Arunthamakun, Justin | |
dc.contributor.author | Athavale, Ambarish M. | |
dc.contributor.author | Friedman, Allon N. | |
dc.contributor.author | Short, Samuel A.P. | |
dc.contributor.author | Kibbelaar, Zoe A. | |
dc.contributor.author | Omar, Samah Abu | |
dc.contributor.author | Admon, Andrew J. | |
dc.contributor.author | Donnelly, John P. | |
dc.contributor.author | Gershengorn, Hayley B. | |
dc.contributor.author | Hernán, Miguel A. | |
dc.contributor.author | Semler, Matthew W. | |
dc.contributor.author | Leaf, David E. | |
dc.contributor.department | Medicine, School of Medicine | en_US |
dc.date.accessioned | 2023-02-06T13:03:56Z | |
dc.date.available | 2023-02-06T13:03:56Z | |
dc.date.issued | 2020-11 | |
dc.description.abstract | Importance: The US is currently an epicenter of the coronavirus disease 2019 (COVID-19) pandemic, yet few national data are available on patient characteristics, treatment, and outcomes of critical illness from COVID-19. Objectives: To assess factors associated with death and to examine interhospital variation in treatment and outcomes for patients with COVID-19. Design, setting, and participants: This multicenter cohort study assessed 2215 adults with laboratory-confirmed COVID-19 who were admitted to intensive care units (ICUs) at 65 hospitals across the US from March 4 to April 4, 2020. Exposures: Patient-level data, including demographics, comorbidities, and organ dysfunction, and hospital characteristics, including number of ICU beds. Main outcomes and measures: The primary outcome was 28-day in-hospital mortality. Multilevel logistic regression was used to evaluate factors associated with death and to examine interhospital variation in treatment and outcomes. Results: A total of 2215 patients (mean [SD] age, 60.5 [14.5] years; 1436 [64.8%] male; 1738 [78.5%] with at least 1 chronic comorbidity) were included in the study. At 28 days after ICU admission, 784 patients (35.4%) had died, 824 (37.2%) were discharged, and 607 (27.4%) remained hospitalized. At the end of study follow-up (median, 16 days; interquartile range, 8-28 days), 875 patients (39.5%) had died, 1203 (54.3%) were discharged, and 137 (6.2%) remained hospitalized. Factors independently associated with death included older age (≥80 vs <40 years of age: odds ratio [OR], 11.15; 95% CI, 6.19-20.06), male sex (OR, 1.50; 95% CI, 1.19-1.90), higher body mass index (≥40 vs <25: OR, 1.51; 95% CI, 1.01-2.25), coronary artery disease (OR, 1.47; 95% CI, 1.07-2.02), active cancer (OR, 2.15; 95% CI, 1.35-3.43), and the presence of hypoxemia (Pao2:Fio2<100 vs ≥300 mm Hg: OR, 2.94; 95% CI, 2.11-4.08), liver dysfunction (liver Sequential Organ Failure Assessment score of 2-4 vs 0: OR, 2.61; 95% CI, 1.30-5.25), and kidney dysfunction (renal Sequential Organ Failure Assessment score of 4 vs 0: OR, 2.43; 95% CI, 1.46-4.05) at ICU admission. Patients admitted to hospitals with fewer ICU beds had a higher risk of death (<50 vs ≥100 ICU beds: OR, 3.28; 95% CI, 2.16-4.99). Hospitals varied considerably in the risk-adjusted proportion of patients who died (range, 6.6%-80.8%) and in the percentage of patients who received hydroxychloroquine, tocilizumab, and other treatments and supportive therapies. Conclusions and relevance: This study identified demographic, clinical, and hospital-level risk factors that may be associated with death in critically ill patients with COVID-19 and can facilitate the identification of medications and supportive therapies to improve outcomes. | en_US |
dc.identifier.citation | Gupta S, Hayek SS, Wang W, et al. Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US [published correction appears in JAMA Intern Med. 2020 Nov 1;180(11):1555] [published correction appears in JAMA Intern Med. 2021 Aug 1;181(8):1144]. JAMA Intern Med. 2020;180(11):1436-1447. doi:10.1001/jamainternmed.2020.3596 | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/31149 | |
dc.language.iso | en_US | en_US |
dc.publisher | American Medical Association | en_US |
dc.relation.isversionof | 10.1001/jamainternmed.2020.3596 | en_US |
dc.relation.journal | JAMA Internal Medicine | en_US |
dc.rights | Publisher Policy | en_US |
dc.source | PMC | en_US |
dc.subject | COVID-19 | en_US |
dc.subject | Critical illness | en_US |
dc.subject | Hospital mortality | en_US |
dc.subject | Intensive Care Units | en_US |
dc.title | Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US | en_US |
dc.type | Article | en_US |
ul.alternative.fulltext | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364338/ | en_US |
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