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Showing content from https://pubmed.ncbi.nlm.nih.gov/36040111/ below:

Variation in the risk of death due to COVID-19: An international multicenter cohort study of hospitalized adults

Multicenter Study

Collaborators, Affiliations

• COVID-ACE Group:

• ¹ Department of Medicine, Sinai Health System, University of Toronto, Toronto, Ontario, Canada.
• ² Division of Internal Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
• ³ Interdepartmental Division of Palliative Care, Sinai Health System, University of Toronto, Toronto, Ontario, Canada.
• ⁴ Department of Medicine, Division of Cardiology, Women's College Hospital, Toronto, Ontario, Canada.
• ⁵ Department of Medicine, University Health Network, Toronto, Ontario, Canada.
• ⁶ Department of Medicine, Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.
• ⁷ Department of Pharmacy, Trillium Health Partners, Mississauga, Ontario, Canada.
• ⁸ Department of Cardiology, University of Copenhagen, Copenhagen, Denmark.
• ⁹ Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
• ¹⁰ Department of Medicine, Michael Garron Hospital, Toronto, Ontario, Canada.
• ¹¹ Department of Medicine, Southlake Regional Health Centre, Newmarket, Ontario, Canada.
• ¹² Department of Medicine, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.
• ¹³ Department of Medicine, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
• ¹⁴ Department of Epidemiology, School of Public Health, Boston University, Massachusetts, Boston, USA.
• ¹⁵ Department of Medicine, Division of General Internal Medicine and Geriatrics, Sinai Health and the University Health Network, Toronto, Ontario, Canada.
• ¹⁶ Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

• PMID: 36040111
• PMCID: PMC9539016
• DOI: 10.1002/jhm.12946

Item in Clipboard

Multicenter Study

Kieran L Quinn et al. J Hosp Med. 2022 Oct.

• COVID-ACE Group:

• ¹ Department of Medicine, Sinai Health System, University of Toronto, Toronto, Ontario, Canada.
• ² Division of Internal Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
• ³ Interdepartmental Division of Palliative Care, Sinai Health System, University of Toronto, Toronto, Ontario, Canada.
• ⁴ Department of Medicine, Division of Cardiology, Women's College Hospital, Toronto, Ontario, Canada.
• ⁵ Department of Medicine, University Health Network, Toronto, Ontario, Canada.
• ⁶ Department of Medicine, Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.
• ⁷ Department of Pharmacy, Trillium Health Partners, Mississauga, Ontario, Canada.
• ⁸ Department of Cardiology, University of Copenhagen, Copenhagen, Denmark.
• ⁹ Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
• ¹⁰ Department of Medicine, Michael Garron Hospital, Toronto, Ontario, Canada.
• ¹¹ Department of Medicine, Southlake Regional Health Centre, Newmarket, Ontario, Canada.
• ¹² Department of Medicine, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.
• ¹³ Department of Medicine, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
• ¹⁴ Department of Epidemiology, School of Public Health, Boston University, Massachusetts, Boston, USA.
• ¹⁵ Department of Medicine, Division of General Internal Medicine and Geriatrics, Sinai Health and the University Health Network, Toronto, Ontario, Canada.
• ¹⁶ Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

• PMID: 36040111
• PMCID: PMC9539016
• DOI: 10.1002/jhm.12946

Item in Clipboard

Background: There is wide variation in mortality among patients hospitalized with COVID-19. Whether this is related to patient or hospital factors is unknown.

Objective: To compare the risk of mortality for patients hospitalized with COVID-19 and to determine whether the majority of that variation was explained by differences in patient characteristics across sites.

Design, setting, and participants: An international multicenter cohort study of hospitalized adults with laboratory-confirmed COVID-19 enrolled from 10 hospitals in Ontario, Canada and 8 hospitals in Copenhagen, Denmark between January 1, 2020 and November 11, 2020.

Main outcomes and measures: Inpatient mortality. We used a multivariable multilevel regression model to compare the in-hospital mortality risk across hospitals and quantify the variation attributable to patient-level factors.

Results: There were 1364 adults hospitalized with COVID-19 in Ontario (n = 1149) and in Denmark (n = 215). In Ontario, the absolute risk of in-hospital mortality ranged from 12.0% to 39.8% across hospitals. Ninety-eight percent of the variation in mortality in Ontario was explained by differences in the characteristics of the patients. In Denmark, the absolute risk of inpatients ranged from 13.8% to 20.6%. One hundred percent of the variation in mortality in Denmark was explained by differences in the characteristics of the inpatients.

Conclusion: There was wide variation in inpatient COVID-19 mortality across hospitals, which was largely explained by patient-level factors, such as age and severity of presenting illness. However, hospital-level factors that could have affected care, including resource availability and capacity, were not taken into account. These findings highlight potential limitations in comparing crude mortality rates across hospitals for the purposes of reporting on the quality of care.

© 2022 Society of Hospital Medicine.

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Mike Fralick is a consultant for ProofDx a start‐up company that has created a point‐of‐care test for COVID‐19 using CRISPR.

CONSORT diagram for the creation…

CONSORT diagram for the creation of the study sample. All adults hospitalized with…

CONSORT diagram for the creation of the study sample. All adults hospitalized with laboratory‐confirmed coronavirus disease 2019 (COVID‐19) between January 1, 2020 and November 11, 2020 across 10 hospitals in Ontario, Canada and 8 hospitals in Copenhagen, Denmark were included in the study.

Plots of key patient factors…

Plots of key patient factors and outcomes demonstrating variation across study sites among…

Plots of key patient factors and outcomes demonstrating variation across study sites among adults hospitalized with laboratory‐confirmed coronavirus disease 2019 (COVID‐19) between January 1, 2020 and November 11, 2020 across 10 hospitals in Ontario, Canada. All outcomes were censored at 30 days.

• Association Between Diabetes and Mortality Among Adult Patients Hospitalized With COVID-19: A Cohort Study of Hospitalized Adults in Ontario, Canada, and Copenhagen, Denmark.

  Bogler O, Raissi A, Colacci M, Beaman A, Biering-Sørensen T, Cressman A, Detsky A, Gosset A, Lassen MH, Kandel C, Khaykin Y, Barbosa D, Lapointe-Shaw L, MacFadden DR, Pearson A, Perkins BA, Rothman KJ, Skaarup KG, Weagle R, Yarnell C, Sholzberg M, Hodzic-Santor B, Lovblom E, Zipursky J, Quinn KL, Fralick M. Bogler O, et al. Can J Diabetes. 2023 Jun;47(4):352-358. doi: 10.1016/j.jcjd.2023.02.005. Epub 2023 Feb 23. Can J Diabetes. 2023. PMID: 37074240 Free PMC article.

• Mortality trends and length of stays among hospitalized patients with COVID-19 in Ontario and Québec (Canada): a population-based cohort study of the first three epidemic waves.

  Xia Y, Ma H, Buckeridge DL, Brisson M, Sander B, Chan A, Verma A, Ganser I, Kronfli N, Mishra S, Maheu-Giroux M. Xia Y, et al. Int J Infect Dis. 2022 Aug;121:1-10. doi: 10.1016/j.ijid.2022.04.048. Epub 2022 Apr 25. Int J Infect Dis. 2022. PMID: 35477050 Free PMC article.

• Trends in Venous Thromboembolism Anticoagulation in Patients Hospitalized With COVID-19.

  Vaughn VM, Yost M, Abshire C, Flanders SA, Paje D, Grant P, Kaatz S, Kim T, Barnes GD. Vaughn VM, et al. JAMA Netw Open. 2021 Jun 1;4(6):e2111788. doi: 10.1001/jamanetworkopen.2021.11788. JAMA Netw Open. 2021. PMID: 34115129 Free PMC article.

• Trends in Patient Characteristics and COVID-19 In-Hospital Mortality in the United States During the COVID-19 Pandemic.

  Roth GA, Emmons-Bell S, Alger HM, Bradley SM, Das SR, de Lemos JA, Gakidou E, Elkind MSV, Hay S, Hall JL, Johnson CO, Morrow DA, Rodriguez F, Rutan C, Shakil S, Sorensen R, Stevens L, Wang TY, Walchok J, Williams J, Murray C. Roth GA, et al. JAMA Netw Open. 2021 May 3;4(5):e218828. doi: 10.1001/jamanetworkopen.2021.8828. JAMA Netw Open. 2021. PMID: 33938933 Free PMC article.

• Pitfalls when comparing COVID-19-related outcomes across studies-lessons learnt from the ERACODA collaboration.

  Noordzij M, Vart P, Duivenvoorden R, Franssen CFM, Hemmelder MH, Jager KJ, Hilbrands LB, Gansevoort RT. Noordzij M, et al. Clin Kidney J. 2021 Feb 2;14(Suppl 1):i14-i20. doi: 10.1093/ckj/sfab027. eCollection 2021 Mar. Clin Kidney J. 2021. PMID: 33796283 Free PMC article. Review.

• Wastewater Monitoring for Infectious Disease: Intentional Relationships between Academia, the Private Sector, and Local Health Departments for Public Health Preparedness.

  Ram JL, Shuster W, Gable L, Turner CL, Hartrick J, Vasquez AA, West NW, Bahmani A, David RE. Ram JL, et al. Int J Environ Res Public Health. 2023 Aug 25;20(17):6651. doi: 10.3390/ijerph20176651. Int J Environ Res Public Health. 2023. PMID: 37681792 Free PMC article.

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