Hospital length of Stay among COVID-19 Patients: An Application of Competing Risk Analysis
-
Yousef Alimohamadi
,
Mojtaba Sepandi
,
Aniseh Dadgar
,
Homeira Sedighi Nezhad
,
Reza Mosaed
,
Sanaz Zargar Balaye Jame
Abstract
Introduction: In the present study, the goal was to estimate the hospital length of stay among patients admitted with COVID-19 in a hospital in Tehran.
Methods: We used retrospective data on 446 hospitalized patients with COVID-19 who admitted from 7 March to 8 Oct 2020 in a referral hospital in Tehran, Iran. The prognostic effects of variables, including age, gender, comorbidity status, and symptoms were analyzed by using Kaplan-Meier methods and a competing risk analysis. Length of stay in hospital was calculated using time of last status minus time of admission. All analyses performed using SPSS version 22.0 and STATA version 15.
Results: The mean age of cases was 57.09±16.85 years old. The median (IQR) of hospital length of stay among all patients was 7 (11-5) days. The length of Hospital stay, for >80 years’ patients (9days (15-5)) and females (7days (11-5)) was the longest. The most of cases (94 (21.1%)) were in 60–69 age group. In overall 267 (59.9%) of all cases were males and 179 (40.1%) were females. The most common symptom among patients was Respiratory distress 249 (55.8), Cough 233 (52.2) and fever 209 (46.9) respectively. Regarding having any comorbidities, 106 (23.8%) of COVID-19 cases had Cardiovascular disease, 114 (25.6%) had diabetes and 100 (22.4%) had hypertension. Most of deaths (21 (32.3%)) occurred in 70-79 years’ age group. The overall Case Fatality Rate (CFR) in under-studied cases was 14.6%.
Conclusion: Although the result of the present study showed that hospital length of stay in Iran is not higher than in other countries, but by applying some measures including the early detection of suspected cases and timely treatment and necessary funding on preparing required facilities, medicine and equipment, it could be shortened or at least prevented from increasing.
2. Reported Cases and Deaths by Country, Territory, or Conveyance [https://www.worldometers. info/coronavirus/#countries]
3. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei YJTL: Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. 2020, 395(10223):507-513.
4. Nikpouraghdam M, Jalali Farahani A, Alishiri G, Heydari S, Ebrahimnia M, Samadinia H, Sepandi M, Jafari NJ, Izadi M, Qazvini A et al: Epidemiological characteristics of coronavirus disease 2019 (COVID-19) patients in IRAN: A single center study. J Clin Virol 2020, 127:104378-104378.
5. Lancet TJL: COVID-19: protecting health-care workers. 2020, 395(10228):922.
6. Novel CPEREJZlxbxzzZlz: The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. 2020, 41(2):145.
7. Nicastri E, D’Abramo A, Faggioni G, De Santis R, Mariano A, Lepore L, Molinari F, Petralito G, Fillo S, Munzi DJE: Coronavirus disease (COVID-19) in a paucisymptomatic patient: epidemiological and clinical challenge in settings with limited community transmission, Italy, February 2020. 2020, 25(11):2000230.
8. McMichael TM, Currie DW, Clark S, Pogosjans S, Kay M, Schwartz NG, Lewis J, Baer A, Kawakami V, Lukoff MDJNEJoM: Epidemiology of Covid-19 in a long-term care facility in King County, Washington. 2020, 382(21):2005-2011.
9. Wu Z, McGoogan JMJJ: Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. 2020, 323(13):1239-1242.
10. Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, Ji R, Wang H, Wang Y, Zhou YJIjoid: Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and metaanalysis. 2020.
11. Ji JS, Liu Y, Liu R, Zha Y, Chang X, Zhang L, Zhang Y, Zeng J, Dong T, Xu XJm: Survival analysis of hospital length of stay of novel coronavirus (COVID-19) pneumonia patients in Sichuan, China. 2020.
12. Thai PQ, Dinh TS, Van Hoang TH, Luu NM, Hung LX, Luu NH, Duong HL, Luong NK, Nguyen TK, Le THJE et al: Factors associated with the duration of hospitalization among COVID-19 patients in Vietnam: A survival analysis. 2020:1-20.
13. Rosenbaum LJNEJoM: Facing Covid-19 in Italy—ethics, logistics, and therapeutics on the epidemic’s front line. 2020, 382(20):1873-1875.
14. Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, Zhang LJ: Coronavirus disease 2019 (COVID-19): a perspective from China. Radiology 2020:200490.
15. Zareie B, Roshani A, Mansournia MA, Rasouli MA, Moradi G: A model for COVID-19 prediction in Iran based on China parameters. medRxiv 2020.
16. Alimohamadi Y, Sepandi M, Taghdir M, Hosamirudsari H: Determine the most common clinical symptoms in COVID-19 patients: a systematic review and meta-analysis. Journal of preventive medicine and hygiene 2020, 61(3):E304.
17. Sepandi M, Taghdir M, Alimohamadi Y, Afrashteh S, Hosamirudsari H: Factors Associated with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis. Iranian Journal of Public Health 2020, 49(7):1211.
18. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y: Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet 2020, 395(10223):507-513.
19. Khoshnood RJ, Ommi D, Zali A, Ashrafi F, Vahidi M, Azhide A, Shirini D, Sanadgol G, Khave LJ, Nohesara S: Epidemiological Characteristics, Clinical Features, and Outcome of COVID-19 Patients in Northern Tehran, Iran; a Cross-Sectional Study. Advanced Journal of Emergency Medicine 2020.
20. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peña R, HolguinRivera Y, Escalera-Antezana JP, Alvarado-Arnez LE, Bonilla-Aldana DK, Franco-Paredes C, HenaoMartinez AF: Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel medicine and infectious disease
2020:101623.
21. Severe outcomes among patients with coronavirus disease 2019 (COVID-19)United States, February 12–March 16, 2020. MMWR. Morbidity and Mortality Weekly Report [ https://www.cdc.gov/mmwr/ volumes/69/wr/mm6912e2.htm.]
22. Lescure F-X, Bouadma L, Nguyen D, Parisey M, Wicky P-H, Behillil S, Gaymard A, BouscambertDuchamp M, Donati F, Le Hingrat QJTLID: Clinical and virological data of the first cases of COVID-19 in Europe: a case series. 2020.
23. Wise J: A third of covid-19 patients admitted to UK hospitals die. In.: British Medical Journal Publishing Group; 2020.
24. Petrilli CM, Jones SA, Yang J, Rajagopalan H, O'Donnell LF, Chernyak Y, Tobin K, Cerfolio RJ, Francois F, Horwitz LIJM: Factors associated with hospitalization and critical illness among 4,103 patients with COVID-19 disease in New York City. 2020.
25. Ji JS, Liu Y, Liu R, Zha Y, Chang X, Zhang L, Zhang Y, Zeng J, Dong T, Xu X: Survival analysis of hospital length of stay of novel coronavirus (COVID-19) pneumonia patients in Sichuan, China. medRxiv 2020.
26. Nuñez DDF, Leon L, Mucientes A, RodriguezRodriguez L, Urgelles JF, García AM, Colomer JI, Jover JA, Fernandez-Gutierrez B, Abasolo L: Risk factors for hospital admissions related to COVID-19 in patients with autoimmune inflammatory rheumatic diseases. Annals of the Rheumatic Diseases 2020, 79(11):1393-1399.
27. Bhatraju PK, Ghassemieh BJ, Nichols M, Kim R, Jerome KR, Nalla AK, Greninger AL, Pipavath S, Wurfel MM, Evans L: Covid-19 in critically ill patients in the Seattle region—case series. New England Journal of Medicine 2020, 382(21):2012-2022.
28. Gianfrancesco M, Hyrich KL, Al-Adely S, Carmona L, Danila MI, Gossec L, Izadi Z, Jacobsohn L, Katz P, Lawson-Tovey S: Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry. Annals of the Rheumatic Diseases 2020
| Files | ||
| Issue | Vol 7 No 3 (2021) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jbe.v7i3.7294 | |
| Keywords | ||
| Hospital Length of Stay COVID-19 Competing risk analysis | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
