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Trends in Patient Characteristics and COVID-19 In-Hospital Mortality in the United States During the COVID-19 Pandemic.
Roth, Gregory A; Emmons-Bell, Sophia; Alger, Heather M; Bradley, Steven M; Das, Sandeep R; de Lemos, James A; Gakidou, Emmanuela; Elkind, Mitchell S V; Hay, Simon; Hall, Jennifer L; Johnson, Catherine O; Morrow, David A; Rodriguez, Fatima; Rutan, Christine; Shakil, Saate; Sorensen, Reed; Stevens, Laura; Wang, Tracy Y; Walchok, Jason; Williams, Joseph; Murray, Christopher.
  • Roth GA; Division of Cardiology, Department of Medicine, University of Washington, Seattle.
  • Emmons-Bell S; Division of Cardiology, Department of Medicine, University of Washington, Seattle.
  • Alger HM; American Heart Association, Dallas, Texas.
  • Bradley SM; Minneapolis Heart Institute, Minneapolis, Minnesota.
  • Das SR; Minneapolis Heart Institute Foundation, Minneapolis, Minnesota.
  • de Lemos JA; Associate Editor, JAMA Network Open.
  • Gakidou E; Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas.
  • Elkind MSV; Parkland Health and Hospital System, Dallas, Texas.
  • Hay S; Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas.
  • Hall JL; Parkland Health and Hospital System, Dallas, Texas.
  • Johnson CO; Division of Cardiology, Department of Medicine, University of Washington, Seattle.
  • Morrow DA; Department of Neurology, Vagelos College of Physicians and Surgeons, New York, New York.
  • Rodriguez F; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
  • Rutan C; Division of Cardiology, Department of Medicine, University of Washington, Seattle.
  • Shakil S; American Heart Association, Dallas, Texas.
  • Sorensen R; University of Minnesota, Minneapolis.
  • Stevens L; Division of Cardiology, Department of Medicine, University of Washington, Seattle.
  • Wang TY; Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts.
  • Walchok J; Cardiovascular Institute, Division of Cardiovascular Medicine, Stanford University, Stanford, California.
  • Williams J; American Heart Association, Dallas, Texas.
  • Murray C; Division of Cardiology, Department of Medicine, University of Washington, Seattle.
JAMA Netw Open ; 4(5): e218828, 2021 05 03.
Artículo en Inglés | MEDLINE | ID: covidwho-1210568
ABSTRACT
Importance In-hospital mortality rates from COVID-19 are high but appear to be decreasing for selected locations in the United States. It is not known whether this is because of changes in the characteristics of patients being admitted.

Objective:

To describe changing in-hospital mortality rates over time after accounting for individual patient characteristics. Design, Setting, and

Participants:

This was a retrospective cohort study of 20 736 adults with a diagnosis of COVID-19 who were included in the US American Heart Association COVID-19 Cardiovascular Disease Registry and admitted to 107 acute care hospitals in 31 states from March through November 2020. A multiple mixed-effects logistic regression was then used to estimate the odds of in-hospital death adjusted for patient age, sex, body mass index, and medical history as well as vital signs, use of supplemental oxygen, presence of pulmonary infiltrates at admission, and hospital site. Main Outcomes and

Measures:

In-hospital death adjusted for exposures for 4 periods in 2020.

Results:

The registry included 20 736 patients hospitalized with COVID-19 from March through November 2020 (9524 women [45.9%]; mean [SD] age, 61.2 [17.9] years); 3271 patients (15.8%) died in the hospital. Mortality rates were 19.1% in March and April, 11.9% in May and June, 11.0% in July and August, and 10.8% in September through November. Compared with March and April, the adjusted odds ratios for in-hospital death were significantly lower in May and June (odds ratio, 0.66; 95% CI, 0.58-0.76; P < .001), July and August (odds ratio, 0.58; 95% CI, 0.49-0.69; P < .001), and September through November (odds ratio, 0.59; 95% CI, 0.47-0.73). Conclusions and Relevance In this cohort study, high rates of in-hospital COVID-19 mortality among registry patients in March and April 2020 decreased by more than one-third by June and remained near that rate through November. This difference in mortality rates between the months of March and April and later months persisted even after adjusting for age, sex, medical history, and COVID-19 disease severity and did not appear to be associated with changes in the characteristics of patients being admitted.
Asunto(s)

Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Neumonía Viral / Factores de Tiempo / Mortalidad Hospitalaria / COVID-19 / Hospitalización / Unidades de Cuidados Intensivos Tipo de estudio: Estudio de cohorte / Estudio observacional / Estudio pronóstico Límite: Femenino / Humanos / Masculino / Middle aged País/Región como asunto: America del Norte Idioma: Inglés Revista: JAMA Netw Open Año: 2021 Tipo del documento: Artículo

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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Neumonía Viral / Factores de Tiempo / Mortalidad Hospitalaria / COVID-19 / Hospitalización / Unidades de Cuidados Intensivos Tipo de estudio: Estudio de cohorte / Estudio observacional / Estudio pronóstico Límite: Femenino / Humanos / Masculino / Middle aged País/Región como asunto: America del Norte Idioma: Inglés Revista: JAMA Netw Open Año: 2021 Tipo del documento: Artículo