Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access |
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc |
Journal website https://jocmr.elmerjournals.com |
Original Article
Volume 000, Number 000, March 2025, pages 000-000
Comparative Evaluation of Risk of Death in Mechanically Ventilated Patients With COVID-19 and Influenza: A Population-Based Cohort Study
Figure
Tables
Variables | COVID-19a | Influenzaa | P value |
---|---|---|---|
N = 19,659 | N = 2,536 | ||
aThe parenthesized figures represent percents, except for the Deyo comorbidity index and number of organ dysfunctions; percentage figures may not add to 100 due to rounding. bThe State of Texas suppresses gender data of hospitalizations with HIV infection, alcohol use, and substance use. cMean (standard deviation). dPost-acute care facilities include long-term acute care hospitals, inpatient rehabilitation, skilled nursing facilities, and nursing homes. COVID-19: coronavirus disease 2019; HIV: human immunodeficiency virus; ECMO: extracorporeal membrane oxygenation; Do-not-resuscitate: a do-not-resuscitate state. | |||
Age, years | 0.9212 | ||
18 - 44 | 2,252 (11.5) | 285 (11.2) | |
45 - 64 | 6,612 (33.6) | 861 (34.0) | |
≥ 65 | 10,795 (54.9) | 1,390 (54.8) | |
Gender | |||
Female | 8,189 (41.7) | 1,220 (48.1) | < 0.0001 |
Male | 10,036 (51.1) | 1,026 (40.6) | |
Suppressedb | 1,434 (7.3) | 290 (11.4) | |
Race/ethnicity | < 0.0001 | ||
White | 9,974 (50.7) | 1,308 (51.6) | |
Hispanic | 5,413 (27.5) | 557 (22.0) | |
Black | 2,755 (14.0) | 504 (19.9) | |
Other | 1,517 (7.7) | 167 (6.6) | |
Health insurance | < 0.0001 | ||
Private | 8,597 (43.7) | 1,085 (42.8) | |
Medicare | 6,909 (35.1) | 846 (33.4) | |
Medicaid | 1,383 (7.0) | 238 (9.4) | |
Uninsured | 1,688 (8.6) | 297 (11.7) | |
Other | 869 (4.4) | 57 (2.2) | |
Missing | 213 (1.1) | 13 (0.5) | |
Deyo comorbidity indexc | 2.04 (2.03) | 2.53 (1.91) | < 0.0001 |
Comorbid conditions | |||
Diabetes | 8,341 (42.4) | 990 (39.0) | 0.0011 |
Liver disease | 1,125 (5.7) | 136 (5.4) | 0.5386 |
Malignancy | 1,272 (6.5) | 145 (5.7) | 0.1216 |
Congestive heart failure | 6,639 (33.8) | 1,231 (48.5) | < 0.0001 |
Chronic lung disease | 5,597 (28.5) | 1,463 (57.7) | < 0.0001 |
Myocardial infarction | 2,998 (15.3) | 475 (18.7) | < 0.0001 |
Peripheral vascular disease | 715 (3.6) | 107 (4.2) | 0.1304 |
Dementia | 1,509 (7.7) | 163 (6.4) | 0.0197 |
Peptic ulcer disease | 303 (1.5) | 33 (1.3) | 0.4320 |
Hemiplegia/paraplegia | 535 92.7) | 46 (1.8) | 0.0073 |
HIV | 99 (0.5) | 18 (0.7) | 0.1882 |
Cerebrovascular disease | 1,684 (8.6) | 161 (6.3) | 0.0001 |
Chronic renal disease | 4,994 (25.4) | 588 (23.2) | 0.0163 |
Rheumatological disease | 614 (3.1) | 101 (4.0) | 0.0154 |
Obesity | 6,605 (33.6) | 781 (30.8) | 0.0049 |
Tobacco use | 1,938 (9.9) | 564 (22.2) | < 0.0001 |
Alcohol use | 745 (3.8) | 121 (4.8) | 0.0145 |
Substance use | 767 (3.9) | 176 (6.9) | < 0.0001 |
Number of organ dysfunctionsc | 2.60 (1.37) | 2.13 (1.27) | < 0.0001 |
Hemodialysis | 1,493 (7.6) | 114 (4.5) | < 0.0001 |
ECMO | 63 (0.3) | 2 (0.07) | 0.0369 |
Do-not-resuscitate | 6,513 (33.1) | 483 (19.0) | < 0.0001 |
Palliative care | 4,348 (22.1) | 318 (12.5) | < 0.0001 |
Teaching hospital | 5,093 (25.9) | 684 (27.0) | 0.2348 |
Hospital admission period | |||
Fourth quarter 2021 | 5,646 (28.7) | 137 (5.4) | < 0.0001 |
First quarter 2022 | 7,792 (39.6) | 305 (12.0) | < 0.0001 |
Second quarter 2022 | 716 (3.6) | 261 (10.3) | < 0.0001 |
Third quarter 2022 | 2,267 (11.5) | 101 (4.0) | < 0.0001 |
Fourth quarter 2022 | 1,281 (6.5) | 1,230 (48.5) | < 0.0001 |
First quarter 2023 | 1,957 (10.0) | 502 (19.8) | < 0.0001 |
Hospital disposition | |||
In- hospital mortality | 7,968 (40.5) | 342 (13.5) | < 0.0001 |
Hospice | 1,675 (8.5) | 182 (7.2) | 0.0259 |
Home | 5,837 (29.7) | 1,459 (57.5) | < 0.0001 |
Post-acute care facilityd | 3,892 (19.8) | 488 (19.2) | 0.4749 |
Leave against medical advice | 287 (1.5) | 65 (2.6) | < 0.0001 |
Modelb | aRR (95% CI)c | aRDd (95% CI)c |
---|---|---|
aShort-term mortality is the composite of in-hospital death or discharge to hospice. bAll models were adjusted for patients’ sociodemographic characteristics, coexisting conditions, measures of severity of illness, organ support, use of palliative care, do-not-resuscitate status, hospitals’ teaching status, and year and calendar quarter of hospitalization. cNon-parametric bootstrap 95% CIs were determined using 10,000 bootstrap samples. dThe risk difference represents the absolute difference in risk of short-term mortality between mechanically ventilated hospitalizations with COVID-19 vs. those with influenza, expressed as percentage. COVID-19: coronavirus disease 2019; aRR: adjusted risk ratio; CI: confidence interval; aRD: adjusted risk difference. | ||
Overlap propensity score weighting | 1.24 (1.18 - 1.30) | 8.8 (6.7 - 10.4) |
Alternative analyses | ||
Entropy balance | 1.25 (1.19 - 1.33) | 9.3 (7.4 - 11.7) |
Hierarchical multivariable logistic regression | 1.23 (1.22 - 1.34) | 8.8 (8.3 - 12.0) |