[Comparison of the demographic characteristics and comorbidities of patients with COVID-19 who died in Spanish hospitals based on whether they were or were not admitted to an intensive care unit]. / Comparación de las características demográficas y comorbilidad de los pacientes con COVID-19 fallecidos en hospitales españoles, en función de si ingresaron o no en Cuidados Intensivos.
Med Intensiva (Engl Ed)
; 45(1): 14-26, 2021.
Article
in English, Spanish
| MEDLINE | ID: covidwho-1065470
ABSTRACT
OBJECTIVE:
To describe and compare the demographic characteristics and comorbidities of patients with COVID-19 who died in Spanish hospitals during the 2020 pandemic based on whether they were or were not admitted to an intensive care unit (ICU) prior to death.METHODS:
We performed a secondary analysis of COVID-19 patients who died during hospitalization included by 62 Spanish emergency departments in the SIESTA cohort. We collected the demographic characteristics and comorbidities, determined both individually and estimated globally by the Charlson index (ChI). Independent factors related to ICU admission were identified and different analyses of sensitivity were performed to contrast the consistency of the findings of the principal analysis.RESULTS:
We included the 338 patients from the SIESTA cohort that died during hospitalization. Of these, 77 (22.8%) were admitted to an ICU before dying. After multivariate adjustment, 3 out of the 20 basal characteristics analyzed in the present study were independently associated with ICU admission dementia (no patients with dementia who died were admitted to the ICU OR = 0, 95%CI = not calculable), active cancer (OR = 0.07; 95%CI = 0.02-0.21) and age (< 70 years OR = 1, reference; 70-74 years OR = 0.21; 95%CI = 0.08-0.54; 75-79 years OR = 0.21; 95%CI = 0.08-0.54; ≥ 80 years OR = 0.02; 95%CI = 0.01-0.05). The probability of ICU admission significantly increased in parallel to the ChI, even after adjustment for age (ChI 0 points OR = 0, reference; ChI 1 point OR = 0.36; 95%CI = 0.16-0.83; ChI 2 points OR = 0.36; 95%CI = 0.16-0.83; ChI >2 points OR = 0.09; 95%CI = 0.04-0.23). The sensitivity analyses showed no gross differences compared to the principal analysis.CONCLUSIONS:
The profile of COVID-19 patients who died without ICU admission is similar to that observed in the usual medical practice before the pandemic. The basal characteristics limiting their admission were age and global burden due to comorbidity, especially dementia and active cancer.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Hospital Mortality
/
Pandemics
/
SARS-CoV-2
/
COVID-19
/
Intensive Care Units
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
English
/
Spanish
Journal:
Med Intensiva (Engl Ed)
Year:
2021
Document Type:
Article
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