Predictors of in-hospital mortality in Covid-19: a study across two peripheral district general hospitals in UK

Nil Kamal Samanta*, Samik Kumar Bandyopadhyay, Dodiy Herman, Biman Chakraborty, Adrian Marsh, Subramanian Kumaran, Lauren Burnard, Gunalan Gnanaseelan, Saoirse Gibson, Benita Florence, Saibal Ganguly

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

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 (χ2 =17.12, p<0.001) was found to be an independent predictor of mortality – this was independent of sex (χ2 =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.

Original languageEnglish
Article numbera003
Number of pages10
JournalBritish Journal of Medical Practitioners
Volume14
Issue number1
Publication statusPublished - 31 Jul 2021

Bibliographical note

Funding Information:
Miss Lyndsey Green: Senior BMS, Microbiology, SaTH. Mrs Annette Meredith: ED/AMU Medical Secretary, SaTH. Dr N Zia: Consultant, Emergency medicine, Dudley Group of Hospitals NHS Foundation Trust, Dudley, UK. Dr I Thund: Consultant, Emergency medicine, Dudley Group of Hospitals NHS Foundation Trust, Dudley, UK. Dr S Das: Consultant, Emergency medicine, Stockport NHS Foundation Trust, Stockport, UK. Special thanks to Dr Mohyman El Habishi, Trainee, Anaesthetics, Dudley Group of Hospitals NHS Foundation Trust, Dudley, UK for his contribution of proof-reading, graphics and tables.

Publisher Copyright:
© 2021 BJMP.

Keywords

  • Co-morbidities
  • Covid-19
  • Immunomodulator
  • Mortality

ASJC Scopus subject areas

  • Medicine(all)

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