Dataset Information

Risk factors and early prediction of clinical deterioration and mortality in adult COVID-19 inpatients: an Australian tertiary hospital experience.

ABSTRACT:

Background

Early recognition of severe COVID-19 is essential for timely patient triage.

Aims

To report clinical and laboratory findings and patient outcomes at a tertiary hospital in Melbourne, Australia.

Methods

This is a retrospective study of adult inpatients with COVID-19 admitted to Northern Health from March to September 2020. Data were extracted from electronic medical records.

Results

Key admission data were available for 182 patients (median age 67.0 years (interquartile range, 47.9-83.1); 51.1% female). Fifty-six (30.8%) were from residential care. One hundred and seventeen (64.3%) patients were assigned Goals of Patient Care (GOPC) A or B and 65 (35.7%) GOPC C or D. Comorbidities were present in 135 patients (74.2%). 63.2% of patients received antibiotics, 6.6% had antivirals, 45.6% received systemic glucocorticoid and 3.3% had tocilizumab. Fifty-six (30.8%) developed clinical deterioration (24 requiring ventilation, 21 receiving critical care, 34 died). Overall, inhospital clinical deterioration was significantly associated with older age (P < 0.001), history of diabetes (P = 0.038), lower lymphocyte count (P = 0.002) and platelet count (P = 0.004), higher neutrophil-to-lymphocyte ratio (P = 0.002), elevated fibrinogen (P = 0.004), higher serum ferritin (P = 0.027) and C-reactive protein (CRP; P = 0.002). The accuracy of the 4C Deterioration model was moderate, with an area under the curve (AUC) of 0.79 (95% confidence interval (CI), 0.68-0.90) compared with an AUC of 0.77 (95% CI, 0.76-0.78) in the original validation cohort.

Conclusions

In the present study, high neutrophil-to-lymphocyte ratio, abnormal d-dimer, high serum CRP and ferritin appear to be useful prognostic markers.

SUBMITTER: Brook R

PROVIDER: S-EPMC9011432 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Risk factors and early prediction of clinical deterioration and mortality in adult COVID-19 inpatients: an Australian tertiary hospital experience.

Brook Rowena R Lim Hui Yin HY Ho Prahlad P Choy Kay Weng KW

Internal medicine journal 20220401 4

<h4>Background</h4>Early recognition of severe COVID-19 is essential for timely patient triage.<h4>Aims</h4>To report clinical and laboratory findings and patient outcomes at a tertiary hospital in Melbourne, Australia.<h4>Methods</h4>This is a retrospective study of adult inpatients with COVID-19 admitted to Northern Health from March to September 2020. Data were extracted from electronic medical records.<h4>Results</h4>Key admission data were available for 182 patients (median age 67.0 years ( ...[more]

PMID: 34806276

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Dataset Information

Risk factors and early prediction of clinical deterioration and mortality in adult COVID-19 inpatients: an Australian tertiary hospital experience.

Background

Aims

Methods

Results

Conclusions

Publications

Risk factors and early prediction of clinical deterioration and mortality in adult COVID-19 inpatients: an Australian tertiary hospital experience.

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