Predictors of in-hospital mortality in Covid-19: A study across two peripheral district general hospitals in UK (2021)

Type of publication:
Journal article

Samanta N.K.; Bandyopadhyay S.K.; *Herman D.; Chakraborty B.; *Marsh A.; *Kumaran S.; *Burnard L.; *Gnanaseelan G.; *Gibson S.; *Florence B.; Ganguly S.

British Journal of Medical Practitioners; Jul 2021; vol. 14 (no. 1)

Aim-The mortality from Coronavirus Disease 2019 (COVID-19) has remained a significant medical challenge. Internationally, patient demographics and pre-existing co-morbidities are significant determinants of mortality from COVID-19. The mortality-risk in a local population is difficult to determine. The objective of our study is to examine the risk posed by epidemiological and demographic variables, and co-morbidities in our local population. Method-A retrospective, observational study was conducted on confirmed COVID-19 patients, identified from the local microbiology database. A search of the electronic patient records was performed to collect demographic details and co-morbidities. Chi-square test and logistic regression analysis of the demographic variables and co-morbidities were utilised to calculate the predictive-risk for in-hospital mortality of adult COVID-19 patients. Results-Final analysis included 263 samples. Univariate logistic regression analysis was performed using age as an independent categorical predictor with two cohorts – those <60 and those >=60 years old. Age (2=17.12, p<0.001) was found to be an independent predictor of mortality – this was independent of sex (2=1.784, p<0.182). Charlson Comorbidity Index (CCI) score was found to be a significant predictor of adverse outcome. The odds of death for patients with CCI scores 0-4 was less than half (44.8%) of those with CCI scores >=5 (p=0.005). Patients with no pre-existing medical conditions had a lower mortality-risk (OR=0.181, p=0.022) than those with known medical conditions. Pre-existing renal disease predicted a poor outcome (OR=1.996, p=0.027). The odds of death for the patients coming from their own-home was only 26% of the odds for those from a long-term care-home. Long-term care facility, advanced age (OR=1.058, p <0.001), and long-term oral steroid (OR=3.412, p=0.016) use were all associated with a poor prognosis. Conclusion People aged >=60 years, residence in a long-term care-home, pre-existing renal diseases, a high CCI score and long-term oral steroids use were associated with an increased mortality-risk.

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