Cargando…

Correlates of Coronavirus Disease 2019 Inpatient Mortality at a Southern California Community Hospital With a Predominantly Hispanic/Latino Adult Population

BACKGROUND: Studies of inpatient coronavirus disease 2019 (COVID-19) mortality risk factors have mainly used data from academic medical centers or large multihospital databases and have not examined populations with large proportions of Hispanic/Latino patients. In a retrospective cohort study of 48...

Descripción completa

Detalles Bibliográficos
Autores principales: Gatto, Nicole M, Freund, Debbie, Ogata, Pamela, Diaz, Lisa, Ibarrola, Ace, Desai, Mamta, Aspelund, Thor, Gluckstein, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9887269/
https://www.ncbi.nlm.nih.gov/pubmed/36726553
http://dx.doi.org/10.1093/ofid/ofad011
Descripción
Sumario:BACKGROUND: Studies of inpatient coronavirus disease 2019 (COVID-19) mortality risk factors have mainly used data from academic medical centers or large multihospital databases and have not examined populations with large proportions of Hispanic/Latino patients. In a retrospective cohort study of 4881 consecutive adult COVID-19 hospitalizations at a single community hospital in Los Angeles County with a majority Hispanic/Latino population, we evaluated factors associated with mortality. METHODS: Data on demographic characteristics, comorbidities, laboratory and clinical results, and COVID-19 therapeutics were abstracted from the electronic medical record. Cox proportional hazards regression modeled statistically significant, independently associated predictors of hospital mortality. RESULTS: Age ≥65 years (hazard ratio [HR] = 2.66; 95% confidence interval [CI] = 1.90–3.72), male sex (HR = 1.31; 95% CI = 1.07–1.60), renal disease (HR = 1.52; 95% CI = 1.18–1.95), cardiovascular disease (HR = 1.45; 95% CI = 1.18–1.78), neurological disease (HR = 1.84; 95% CI = 1.41–2.39), D-dimer ≥500 ng/mL (HR = 2.07; 95% CI = 1.43–3.0), and pulse oxygen level <88% (HR = 1.39; 95% CI = 1.13–1.71) were independently associated with increased mortality. Patient household with (1) multiple COVID-19 cases and (2) Asian, Black, or Hispanic compared with White non-Hispanic race/ethnicity were associated with reduced mortality. In hypoxic COVID-19 inpatients, remdesivir, tocilizumab, and convalescent plasma were associated with reduced mortality, and corticosteroid use was associated with increased mortality. CONCLUSIONS: We corroborate several previously identified mortality risk factors and find evidence that the combination of factors associated with mortality differ between populations.