Predictors for inpatient mortality during the first wave of the SARS-CoV-2 pandemic: A retrospective analysis.
Identifieur interne : 000257 ( Main/Exploration ); précédent : 000256; suivant : 000258Predictors for inpatient mortality during the first wave of the SARS-CoV-2 pandemic: A retrospective analysis.
Auteurs : Daniel Sammartino [États-Unis] ; Farrukh Jafri [États-Unis] ; Brennan Cook [États-Unis] ; Lisa La [États-Unis] ; Hyemin Kim [États-Unis] ; John Cardasis [États-Unis] ; Joshua Raff [États-Unis]Source :
- PloS one [ 1932-6203 ] ; 2021.
Abstract
BACKGROUND
The coronavirus disease 2019 (COVID-19) pandemic overwhelmed healthcare systems, highlighting the need to better understand predictors of mortality and the impact of medical interventions.
METHODS
This retrospective cohort study examined data from every patient who tested positive for COVID-19 and was admitted to White Plains Hospital between March 9, 2020, and June 3, 2020. We used binomial logistic regression to analyze data for all patients, and propensity score matching for those treated with hydroxychloroquine and convalescent plasma (CP). The primary outcome of interest was inpatient mortality.
RESULTS
1,108 admitted patients with COVID-19 were available for analysis, of which 124 (11.2%) were excluded due to incomplete data. Of the 984 patients included, 225 (22.9%) died. Risk for death decreased for each day later a patient was admitted [OR 0.970, CI 0.955 to 0.985; p < 0.001]. Elevated initial C-reactive protein (CRP) value was associated with a higher risk for death at 96 hours [OR 1.007, 1.002 to 1.012; p = 0.006]. Hydroxychloroquine and CP administration were each associated with increased mortality [OR 3.4, CI 1.614 to 7.396; p = 0.002, OR 2.8560, CI 1.361 to 6.160; p = 0.006 respectively].
CONCLUSIONS
Elevated CRP carried significant odds of early death. Hydroxychloroquine and CP were each associated with higher risk for death, although CP was without titers and was administered at a median of five days from admission. Randomized or controlled studies will better describe the impact of CP. Mortality decreased as the pandemic progressed, suggesting that institutional capacity for dynamic evaluation of process and outcome measures may benefit COVID-19 survival.
DOI: 10.1371/journal.pone.0251262
PubMed: 33970955
Affiliations:
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uniqKey="Jafri F" first="Farrukh" last="Jafri">Farrukh Jafri</name><affiliation wicri:level="2"><nlm:affiliation>White Plains Hospital, White Plains, New York, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>White Plains Hospital, White Plains, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Cook, Brennan" sort="Cook, Brennan" uniqKey="Cook B" first="Brennan" last="Cook">Brennan Cook</name><affiliation wicri:level="2"><nlm:affiliation>Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey</wicri:regionArea><placeName><region type="state">New Jersey</region></placeName></affiliation></author><author><name sortKey="La, Lisa" sort="La, Lisa" uniqKey="La L" first="Lisa" last="La">Lisa La</name><affiliation wicri:level="2"><nlm:affiliation>White Plains Hospital, White Plains, New York, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>White Plains Hospital, White Plains, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Kim, Hyemin" sort="Kim, Hyemin" uniqKey="Kim H" first="Hyemin" last="Kim">Hyemin Kim</name><affiliation wicri:level="2"><nlm:affiliation>White Plains Hospital, White Plains, New York, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>White Plains Hospital, White Plains, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Cardasis, John" sort="Cardasis, John" uniqKey="Cardasis J" first="John" last="Cardasis">John Cardasis</name><affiliation wicri:level="2"><nlm:affiliation>White Plains Hospital, White Plains, New York, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>White Plains Hospital, White Plains, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Raff, Joshua" sort="Raff, Joshua" uniqKey="Raff J" first="Joshua" last="Raff">Joshua Raff</name><affiliation wicri:level="2"><nlm:affiliation>White Plains Hospital, White Plains, New York, United States of America.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>White Plains Hospital, White Plains, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author></analytic><series><title level="j">PloS one</title><idno type="eISSN">1932-6203</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The coronavirus disease 2019 (COVID-19) pandemic overwhelmed healthcare systems, highlighting the need to better understand predictors of mortality and the impact of medical interventions.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>This retrospective cohort study examined data from every patient who tested positive for COVID-19 and was admitted to White Plains Hospital between March 9, 2020, and June 3, 2020. We used binomial logistic regression to analyze data for all patients, and propensity score matching for those treated with hydroxychloroquine and convalescent plasma (CP). The primary outcome of interest was inpatient mortality.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>1,108 admitted patients with COVID-19 were available for analysis, of which 124 (11.2%) were excluded due to incomplete data. Of the 984 patients included, 225 (22.9%) died. Risk for death decreased for each day later a patient was admitted [OR 0.970, CI 0.955 to 0.985; p < 0.001]. Elevated initial C-reactive protein (CRP) value was associated with a higher risk for death at 96 hours [OR 1.007, 1.002 to 1.012; p = 0.006]. Hydroxychloroquine and CP administration were each associated with increased mortality [OR 3.4, CI 1.614 to 7.396; p = 0.002, OR 2.8560, CI 1.361 to 6.160; p = 0.006 respectively].</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Elevated CRP carried significant odds of early death. Hydroxychloroquine and CP were each associated with higher risk for death, although CP was without titers and was administered at a median of five days from admission. Randomized or controlled studies will better describe the impact of CP. Mortality decreased as the pandemic progressed, suggesting that institutional capacity for dynamic evaluation of process and outcome measures may benefit COVID-19 survival.</p></div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">33970955</PMID><DateRevised><Year>2021</Year><Month>05</Month><Day>13</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">1932-6203</ISSN><JournalIssue CitedMedium="Internet"><Volume>16</Volume><Issue>5</Issue><PubDate><Year>2021</Year></PubDate></JournalIssue><Title>PloS one</Title><ISOAbbreviation>PLoS One</ISOAbbreviation></Journal><ArticleTitle>Predictors for inpatient mortality during the first wave of the SARS-CoV-2 pandemic: A retrospective analysis.</ArticleTitle><Pagination><MedlinePgn>e0251262</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1371/journal.pone.0251262</ELocationID><Abstract><AbstractText Label="BACKGROUND">The coronavirus disease 2019 (COVID-19) pandemic overwhelmed healthcare systems, highlighting the need to better understand predictors of mortality and the impact of medical interventions.</AbstractText><AbstractText Label="METHODS">This retrospective cohort study examined data from every patient who tested positive for COVID-19 and was admitted to White Plains Hospital between March 9, 2020, and June 3, 2020. We used binomial logistic regression to analyze data for all patients, and propensity score matching for those treated with hydroxychloroquine and convalescent plasma (CP). The primary outcome of interest was inpatient mortality.</AbstractText><AbstractText Label="RESULTS">1,108 admitted patients with COVID-19 were available for analysis, of which 124 (11.2%) were excluded due to incomplete data. Of the 984 patients included, 225 (22.9%) died. Risk for death decreased for each day later a patient was admitted [OR 0.970, CI 0.955 to 0.985; p < 0.001]. Elevated initial C-reactive protein (CRP) value was associated with a higher risk for death at 96 hours [OR 1.007, 1.002 to 1.012; p = 0.006]. Hydroxychloroquine and CP administration were each associated with increased mortality [OR 3.4, CI 1.614 to 7.396; p = 0.002, OR 2.8560, CI 1.361 to 6.160; p = 0.006 respectively].</AbstractText><AbstractText Label="CONCLUSIONS">Elevated CRP carried significant odds of early death. Hydroxychloroquine and CP were each associated with higher risk for death, although CP was without titers and was administered at a median of five days from admission. Randomized or controlled studies will better describe the impact of CP. Mortality decreased as the pandemic progressed, suggesting that institutional capacity for dynamic evaluation of process and outcome measures may benefit COVID-19 survival.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Sammartino</LastName><ForeName>Daniel</ForeName><Initials>D</Initials><Identifier Source="ORCID">0000-0003-2932-5012</Identifier><AffiliationInfo><Affiliation>White Plains Hospital, White Plains, New York, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jafri</LastName><ForeName>Farrukh</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>White Plains Hospital, White Plains, New York, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cook</LastName><ForeName>Brennan</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>La</LastName><ForeName>Lisa</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>White Plains Hospital, White Plains, New York, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Hyemin</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>White Plains Hospital, White Plains, New York, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cardasis</LastName><ForeName>John</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>White Plains Hospital, White Plains, New York, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Raff</LastName><ForeName>Joshua</ForeName><Initials>J</Initials><Identifier Source="ORCID">0000-0001-6934-2170</Identifier><AffiliationInfo><Affiliation>White Plains Hospital, White Plains, New York, United States of America.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>05</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>PLoS One</MedlineTA><NlmUniqueID>101285081</NlmUniqueID><ISSNLinking>1932-6203</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CoiStatement>The authors have declared that no competing interests exist.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>01</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>04</Month><Day>23</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>5</Month><Day>10</Day><Hour>18</Hour><Minute>3</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>5</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>5</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33970955</ArticleId><ArticleId IdType="doi">10.1371/journal.pone.0251262</ArticleId><ArticleId IdType="pii">PONE-D-21-01444</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>New Jersey</li><li>État de New York</li></region></list><tree><country name="États-Unis"><region name="État de New York"><name sortKey="Sammartino, Daniel" sort="Sammartino, Daniel" uniqKey="Sammartino D" first="Daniel" last="Sammartino">Daniel Sammartino</name></region><name sortKey="Cardasis, John" sort="Cardasis, John" uniqKey="Cardasis J" first="John" last="Cardasis">John Cardasis</name><name sortKey="Cook, Brennan" sort="Cook, Brennan" uniqKey="Cook B" first="Brennan" last="Cook">Brennan Cook</name><name sortKey="Jafri, Farrukh" sort="Jafri, Farrukh" uniqKey="Jafri F" first="Farrukh" last="Jafri">Farrukh Jafri</name><name sortKey="Kim, Hyemin" sort="Kim, Hyemin" uniqKey="Kim H" first="Hyemin" last="Kim">Hyemin Kim</name><name sortKey="La, Lisa" sort="La, Lisa" uniqKey="La L" first="Lisa" last="La">Lisa La</name><name sortKey="Raff, Joshua" sort="Raff, Joshua" uniqKey="Raff J" first="Joshua" last="Raff">Joshua Raff</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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