• Kenneth E Sands, Richard P Wenzel, Laura E McLean, Kimberly M Korwek, Jonathon D Roach, Karla M Miller, Russell E Poland, L Hayley Burgess, Edmund S Jackson, and Jonathan B Perlin.
• Clinical Services Group, HCA Healthcare, Nashville, Tennessee.
• Infect Control Hosp Epidemiol. 2021 Apr 1; 42 (4): 399-405.

ObjectiveTo determine risk factors for mortality among COVID-19 patients admitted to a system of community hospitals in the United States.DesignRetrospective analysis of patient data collected from the routine care of COVID-19 patients.SettingSystem of >180 acute-care facilities in the United States.ParticipantsAll admitted patients with positive identification of COVID-19 and a documented discharge as of May 12, 2020.MethodsDetermination 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.ResultsIn 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).ConclusionsThe 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.

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