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{ "pk": 15225, "title": "Mortality Variations of COVID-19 from Different Hospital Settings During Different Pandemic Phases: A Multicenter Retrospective Study", "subtitle": null, "abstract": "Introduction:\n Diverse coronavirus disease 2019 (COVID-19) mortalities have been reported but focused on identifying susceptible patients at risk of more severe disease or death. This study aims to investigate the mortality variations of COVID-19 from different hospital settings during different pandemic phases.\n \nMethods:\n We retrospectively included adult (≥18 years) patients who visited emergency departments (ED) of five hospitals in the state of Texas and who were diagnosed with COVID-19 between March–November 2020. The included hospitals were dichotomized into urban and suburban based on their geographic location. The primary outcome was mortality that occurred either during hospital admission or within 30 days after the index ED visit. We used multivariable logistic regression to investigate the associations between independent variables and outcome. Generalized additive models were employed to explore the mortality variation during different pandemic phases.\nResults:\n A total of 1,788 adult patients who tested positive for COVID-19 were included in the study. The median patient age was 54.6 years, and 897 (50%) patients were male. Urban hospitals saw approximately 59.5% of the total patients. A total of 197 patients died after the index ED visit. The analysis indicated visits to the urban hospitals (odds ratio [OR] 2.14, 95% confidence interval [CI], 1.41, 3.23), from March to April (OR 2.04, 95% CI, 1.08, 3.86), and from August to November (OR 2.15, 95% CI, 1.37, 3.38) were positively associated with mortality.\nConclusion:\n Visits to the urban hospitals were associated with a higher risk of mortality in patients with COVID-19 when compared to visits to the suburban hospitals. The mortality risk rebounded and showed significant difference between urban and suburban hospitals since August 2020. Optimal allocation of medical resources may be necessary to bridge this gap in the foreseeable future.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "COVID-19" }, { "word": "SARS-CoV-2" }, { "word": "Mortality" }, { "word": "emergency department" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4s82j8d4", "frozenauthors": [ { "first_name": "Eric", "middle_name": "H.", "last_name": "Chou", "name_suffix": "", "institution": "Baylor Scott and White All Saints Medical Center, Department of Emergency Medicine, Fort Worth, Texas; John Peter Smith Hospital, Department of Emergency Medicine, Fort Worth, Texas", "department": "None" }, { "first_name": "Chih-Hung", "middle_name": "", "last_name": "Wang", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "Chu-Lin", "middle_name": "", "last_name": "Tsai", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "John", "middle_name": "", "last_name": "Garrett", "name_suffix": "", "institution": "Baylor University Medical Center, Department of Emergency Medicine, Dallas, Texas", "department": "None" }, { "first_name": "Toral", "middle_name": "", "last_name": "Bhakta", "name_suffix": "", "institution": "Baylor Scott and White All Saints Medical Center, Department of Emergency Medicine, Fort Worth, Texas", "department": "None" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Shedd", "name_suffix": "", "institution": "Baylor Scott and White All Saints Medical Center, Department of Emergency Medicine, Fort Worth, Texas", "department": "None" }, { "first_name": "Dahlia", "middle_name": "", "last_name": "Hassani", "name_suffix": "", "institution": "Baylor Scott and White All Saints Medical Center, Department of Emergency Medicine, Fort Worth, Texas", "department": "None" }, { "first_name": "Robert", "middle_name": "", "last_name": "Risch", "name_suffix": "", "institution": "Baylor Scott and White Medical Center at Grapevine, Department of Emergency Medicine, Grapevine, Texas", "department": "None" }, { "first_name": "James", "middle_name": "", "last_name": "d’Etienne", "name_suffix": "", "institution": "John Peter Smith Hospital, Department of Emergency Medicine, Fort Worth, Texas", "department": "None" }, { "first_name": "Gerald", "middle_name": "O.", "last_name": "Ogola", "name_suffix": "", "institution": "Baylor Scott & White Research Institute, Dallas, Texas", "department": "None" }, { "first_name": "Matthew", "middle_name": "Huei-Ming", "last_name": "Ma", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "Tsung-Chien", "middle_name": "", "last_name": "Lu", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "Hao", "middle_name": "", "last_name": "Wang", "name_suffix": "", "institution": "Baylor Scott and White All Saints Medical Center, Department of Emergency Medicine, Fort Worth, Texas; John Peter Smith Hospital, Department of Emergency Medicine, Fort Worth, Texas; Baylor University Medical Center, Department of Emergency Medicine, Dallas, Texas", "department": "None" } ], "date_submitted": "2021-03-25T10:10:40Z", "date_accepted": "2021-03-25T10:10:40Z", "date_published": "2021-09-02T23:25:26Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15225/galley/7735/download/" } ] }