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Variability in COVID-19 in-hospital mortality rates between national health service trusts and regions in England: A national observational study for the Getting It Right First Time Programme.
Gray, William K; Navaratnam, Annakan V; Day, Jamie; Babu, Pratusha; Mackinnon, Shona; Adelaja, Ini; Bartlett-Pestell, Sam; Moulton, Chris; Mann, Cliff; Batchelor, Anna; Swart, Michael; Snowden, Chris; Dyer, Philip; Jones, Michael; Allen, Martin; Hopper, Adrian; Rayman, Gerry; Kar, Partha; Wheeler, Andrew; Eve-Jones, Sue; Fong, Kevin J; Machin, John T; Wendon, Julia; Briggs, Tim W R.
Afiliación
  • Gray WK; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Navaratnam AV; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Day J; University College Hospital, London, UK.
  • Babu P; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Mackinnon S; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Adelaja I; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Bartlett-Pestell S; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Moulton C; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Mann C; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Batchelor A; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Swart M; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Snowden C; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Dyer P; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Jones M; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Allen M; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Hopper A; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Rayman G; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Kar P; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Wheeler A; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Eve-Jones S; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Fong KJ; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Machin JT; University College Hospital, London, UK.
  • Wendon J; Getting It Right First Time programme, NHS England and NHS Improvement, London, UK.
  • Briggs TWR; Kings College London, Kings College Hospital, London, UK.
EClinicalMedicine ; 35: 100859, 2021 May.
Article en En | MEDLINE | ID: mdl-33937732
ABSTRACT

BACKGROUND:

A key first step in optimising COVID-19 patient outcomes during future case-surges is to learn from the experience within individual hospitals during the early stages of the pandemic. The aim of this study was to investigate the extent of variation in COVID-19 outcomes between National Health Service (NHS) hospital trusts and regions in England using data from March-July 2020.

METHODS:

This was a retrospective observational study using the Hospital Episode Statistics administrative dataset. Patients aged ≥ 18 years who had a diagnosis of COVID-19 during a hospital stay in England that was completed between March 1st and July 31st, 2020 were included. In-hospital mortality was the primary outcome of interest. In secondary analysis, critical care admission, length of stay and mortality within 30 days of discharge were also investigated. Multilevel logistic regression was used to adjust for covariates.

FINDINGS:

There were 86,356 patients with a confirmed diagnosis of COVID-19 included in the study, of whom 22,944 (26.6%) died in hospital with COVID-19 as the primary cause of death. After adjusting for covariates, the extent of the variation in-hospital mortality rates between hospital trusts and regions was relatively modest. Trusts with the largest baseline number of beds and a greater proportion of patients admitted to critical care had the lowest in-hospital mortality rates.

INTERPRETATION:

There is little evidence of clustering of deaths within hospital trusts. There may be opportunities to learn from the experience of individual trusts to help prepare hospitals for future case-surges.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Tipo de estudio: Observational_studies Idioma: En Revista: EClinicalMedicine Año: 2021 Tipo del documento: Article País de afiliación: Reino Unido

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Tipo de estudio: Observational_studies Idioma: En Revista: EClinicalMedicine Año: 2021 Tipo del documento: Article País de afiliación: Reino Unido