Patient characteristics and admitting vital signs associated with coronavirus disease 2019 (COVID-19)–related mortality among patients admitted with noncritical illness

Abstract

AbstractObjective:To determine risk factors for mortality among COVID-19 patients admitted to a system of community hospitals in the United States.Design:Retrospective analysis of patient data collected from the routine care of COVID-19 patients.Setting:System of >180 acute-care facilities in the United States.Participants:All admitted patients with positive identification of COVID-19 and a documented discharge as of May 12, 2020.Methods: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.Results: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).Conclusions: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.