RT Journal Article
SR Electronic
T1 Hospital bed occupancy rate is an independent risk factor for COVID-19 inpatient mortality: a pandemic epicentre cohort study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e058171
DO 10.1136/bmjopen-2021-058171
VO 12
IS 2
A1 Castagna, Francesco
A1 Xue, Xiaonan
A1 Saeed, Omar
A1 Kataria, Rachna
A1 Puius, Yoram A
A1 Patel, Snehal R
A1 Garcia, Mario J
A1 Racine, Andrew D
A1 Sims, Daniel B
A1 Jorde, Ulrich P
YR 2022
UL http://bmjopen.bmj.com/content/12/2/e058171.abstract
AB Introduction COVID-19 first struck New York City in the spring of 2020, resulting in an unprecedented strain on our healthcare system and triggering multiple changes in public health policy governing hospital operations as well as therapeutic approaches to COVID-19. We examined inpatient mortality at our centre throughout the course of the pandemic.Methods This is a retrospective chart review of clinical characteristics, treatments and outcome data of all patients admitted with COVID-19 from 1 March 2020 to 28 February 2021. Patients were grouped into 3-month quartiles. Hospital strain was assessed as per cent of occupied beds based on a normal bed capacity of 1491.Results Inpatient mortality decreased from 25.0% in spring to 10.8% over the course of the year. During this time, use of remdesivir, steroids and anticoagulants increased; use of hydroxychloroquine and other antibiotics decreased. Daily bed occupancy ranged from 62% to 118%. In a multivariate model with all year’s data controlling for demographics, comorbidities and acuity of illness, percentage of bed occupancy was associated with increased 30-day in-hospital mortality of patients with COVID-19 (0.7% mortality increase for each 1% increase in bed occupancy; HR 1.007, CI 1.001 to 1.013, p=0.004)Conclusion Inpatient mortality from COVID-19 was associated with bed occupancy. Early reduction in epicentre hospital bed occupancy to accommodate acutely ill and resource-intensive patients should be a critical component in the strategic planning for future pandemics.Data are available upon reasonable request. Request for de-identified data and dictionaries will be evaluated on a case-by-case basis after the submission of a research proposal to the corresponding author and the signature of a data access agreement. Data will be available after manuscript publication.