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2019冠状病毒病感染患者的种族差异:一项全国住院患者样本分析。

Racial Disparities in Patients With COVID-19 Infection: A National Inpatient Sample Analysis.

作者信息

Vardar Ufuk, Ilelaboye Ayodeji, Murthi Mukunthan, Atluri Ramtej, Yong Park Dae, Khamooshi Parnia, Ojemolon Pius E, Shaka Hafeez

机构信息

Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA.

Internal Medicine, Ladoke Akintola University of Technology, Ogbomosho, NGA.

出版信息

Cureus. 2023 Feb 15;15(2):e35039. doi: 10.7759/cureus.35039. eCollection 2023 Feb.

Abstract

Introduction Evidence suggests the COVID-19 (coronavirus disease 2019) pandemic highlighted well-known healthcare disparities. This study investigated racial disparities in patients with COVID-19-related hospitalizations utilizing the US (United States) National Inpatient Sample (NIS). Methodology This was a retrospective study conducted utilizing the NIS 2020 database. The NIS was searched for hospitalization of adult patients with COVID-19 infection as a principal diagnosis using ICD-10 (International Classification of Diseases, Tenth Revision) codes. We divided the NIS into four major racial/ethnic groups: White, Black, Hispanic, and others. The primary outcome was inpatient mortality, and the secondary outcomes were the mean length of stay, mean total hospital charges, development of sepsis, septic shock, use of vasopressors, acute respiratory failure, acute respiratory distress syndrome, acute kidney failure, acute myocardial infarction, cardiac arrest, deep vein thrombosis, pulmonary embolism, cerebrovascular accident, and need for mechanical ventilation. Results Compared to White patients, Hispanic patients had higher adjusted inpatient mortality odds (aOR [adjusted odds ratio]: 1.25, 95% CI 1.19-1.33, p<0.001); however, Black patients had similar adjusted mortality odds (aOR: 0.96, 95% CI 0.91-1.01, p=0.212). Black patients and Hispanic patients had a higher mean length of stay (8.01 vs 7.13 days, p<0.001 and 7.67 vs 7.13 days, p<0.001, respectively), adjusted odds of cardiac arrest (aOR: 1.53, 95% CI 1.37-1.71, p<0.001 and aOR: 1.73, 95% CI 1.54-1.94, p<0.001), septic shock (aOR: 1.23, 95% CI 1.13-1.33, p<0.001 and aOR: 1.88, 95% CI 1.73-2.04, p<0.001), and vasopressor use (aOR: 1.32, 95% CI 1.14 - 1.53, p<0.001 and aOR: 1.87, 95% CI 1.62 - 2.16, p<0.001). Conclusion Our study showed that Black and Hispanic patients are at higher risk of adverse outcomes compared to White patients admitted with COVID-19 infection.

摘要

引言 有证据表明,2019年冠状病毒病(COVID-19)大流行凸显了众所周知的医疗保健差异。本研究利用美国国家住院患者样本(NIS)调查了COVID-19相关住院患者的种族差异。

方法 这是一项利用2020年NIS数据库进行的回顾性研究。使用国际疾病分类第十版(ICD-10)编码在NIS中搜索以COVID-19感染作为主要诊断的成年患者住院情况。我们将NIS分为四个主要种族/族裔群体:白人、黑人、西班牙裔和其他群体。主要结局是住院死亡率,次要结局是平均住院时间、平均总住院费用、脓毒症、感染性休克的发生情况、血管活性药物的使用、急性呼吸衰竭、急性呼吸窘迫综合征、急性肾衰竭、急性心肌梗死、心脏骤停深静脉血栓形成、肺栓塞、脑血管意外以及机械通气需求。

结果 与白人患者相比,西班牙裔患者调整后的住院死亡几率更高(调整优势比[aOR]:1.25,95%置信区间[CI]1.19 - 1.33,p<0.001);然而,黑人患者的调整后死亡几率相似(aOR:0.96,95%CI0.91 - 1.01,p = 0.212)。黑人患者和西班牙裔患者的平均住院时间更长(分别为8.01天对7.13天,p<0.001和7.67天对7.13天,p<0.001),心脏骤停的调整几率(aOR:1.53,95%CI1.37 - 1.71,p<0.001和aOR:1.73,95%CI1.54 - 1.94,p<0.001)、感染性休克(aOR:1.23,95%CI1.13 - 1.33,p<0.001和aOR:1.88,95%CI1.73 - 2.04,p<0.001)以及血管活性药物的使用(aOR:1.32,95%CI1.14 - 1.53,p<0.001和aOR:1.87,95%CI1.62 - 2.16,p<0.001)也更高。

结论 我们的研究表明,与因COVID-19感染入院的白人患者相比,黑人和西班牙裔患者出现不良结局的风险更高。

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