Association between race and risk of ICU mortality in mechanically ventilated COVID-19 patients at a safety net hospital.


Journal

Journal of the National Medical Association
ISSN: 1943-4693
Titre abrégé: J Natl Med Assoc
Pays: United States
ID NLM: 7503090

Informations de publication

Date de publication:
Feb 2022
Historique:
received: 28 01 2021
revised: 09 08 2021
accepted: 11 09 2021
pubmed: 8 10 2021
medline: 9 3 2022
entrez: 7 10 2021
Statut: ppublish

Résumé

To determine racial differences in intensive care unit (ICU) mortality outcomes among mechanically ventilated patients with severe coronavirus disease 2019 (COVID-19) infection in a safety net hospital. We retrospectively analyzed a cohort of patients ≥ 18 years old with confirmed severe acute respiratory syndrome-CoV-2 disease associated respiratory failure who were treated with invasive mechanical ventilation and admitted to the ICU from May 1, 2020 - July 30 -2020 at Grady Memorial Hospital, Atlanta, Georgia - a safety net hospital. We evaluated the association between mortality and demographics, co-morbidities, inpatient laboratory, and radiological parameters. Among 181 critically ill mechanically ventilated African American patients treated at a safety net hospital, the mortality rate was 33%. On stratified analysis by race (Table 2), mortality rates were significantly higher in African Americans (39%) and Hispanics (26.3%), compared to Whites (18.9%). On multivariate regression, African Americans were 3 times more likely to die in the ICU compared to Whites (OR 3.1 95% CI 1.6 -5.5). Likewise, the likelihood of mortality was higher in Hispanics compared to Whites (OR 1.3 95% CI 1.0 -3.9). Our study demonstrated a high ICU mortality rate in a cohort of mechanically ventilated patients with severe COVID-19 infection treated at a safety net hospital. African Americans and Hispanics had significantly higher risks of ICU mortality compared to Whites. These study findings further elucidate the disproportionately higher burden of COVID-19 infection in African Americans and Hispanics.

Identifiants

pubmed: 34615602
pii: S0027-9684(21)00208-X
doi: 10.1016/j.jnma.2021.09.003
pmc: PMC8443330
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

18-25

Informations de copyright

Copyright © 2021 National Medical Association. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors of this manuscript have no financial disclosure or conflict of interests to report. All authors contributed to the writing of the manuscript.

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Auteurs

Titilope Olanipekun (T)

Department of Hospital Medicine, Covenant Health System, Knoxville, TN, United States. Electronic address: titilope_olanipekun@teamhealth.com.

Temidayo Abe (T)

Department of Internal Medicine, Morehouse School of Medicine, Atlanta, GA, United States.

Timothy Sobukonla (T)

Department of Internal Medicine, Morehouse School of Medicine, Atlanta, GA, United States.

Jothika Tamizharasu (J)

Department of Internal Medicine, Morehouse School of Medicine, Atlanta, GA, United States.

Linda Gamo (L)

Department of Internal Medicine, Morehouse School of Medicine, Atlanta, GA, United States.

Nelson T Kuete (NT)

Department of Internal Medicine, Morehouse School of Medicine, Atlanta, GA, United States.

Nicolas Bakinde (N)

Department of Internal Medicine, Morehouse School of Medicine, Atlanta, GA, United States.

Gloria Westney (G)

Department of Internal Medicine, Morehouse School of Medicine, Atlanta, GA, United States; Division of Pulmonary and Critical Care Medicine, Morehouse School of Medicine, Atlanta, GA, United States.

Richard H Snyder (RH)

Department of Internal Medicine, Morehouse School of Medicine, Atlanta, GA, United States; Division of Pulmonary and Critical Care Medicine, Morehouse School of Medicine, Atlanta, GA, United States.

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