COVID-19-specific prefectural hospital bed utilization rate and in-hospital mortality among COVID-19 patients throughout the first three years of the pandemic in Japan.

IF 3.7 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Hitomi Kimura, Mariko Hosozawa, Yuta Taniguchi, Kazumasa Yamagishi, Koji Kitajima, Mari Terada, Yusuke Asai, Norio Ohmagari, Hiroyasu Iso
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引用次数: 0

Abstract

Background: We examined the association between the COVID-19-specific prefectural bed utilization rate and in-hospital mortality during the first three years of the pandemic in Japan.

Methods: This nationwide study included 58,175 COVID-19 patients from the COVID-19 Registry Japan, hospitalized between May 1, 2020 and November 30, 2022. Based on the weekly COVID-19-specific bed utilization rate in each prefecture at diagnosis, patients were categorized into four groups (< 25%, 25% to < 50%, 50% to < 75%, and ≥ 75%). Odds ratios (ORs) were estimated by fitting a generalized linear mixed model with prefecture as a random intercept and adjusting for covariates (age, gender, body mass index, smoking and drinking status, and comorbidities). Additional analyses according to age group, gender, and wave of the pandemic were conducted.

Results: We observed 2312 (4.0%) all-cause in-hospital deaths. All-cause in-hospital mortality increased with higher COVID-19 bed utilization rates at diagnosis (OR for multivariable model 1.35, 95% confidence interval [CI] 1.19-1.54 for 25% to <50%; 1.89, 1.66-2.16 for 50 to <75%; 2.16, 1.80-2.58 for ≥75%; P for trend<0.0001). Stronger associations were noted among the younger population (aged <70 years, OR: 3.18, 1.96-5.19) and during the fourth (March 1-June 30, 2021, OR: 3.81, 2.13-6.80) and sixth pandemic waves (January 1-Jun 30, 2022, OR: 2.67, 1.68-4.23).

Conclusions: Our results emphasize that preventing hospital bed shortages during outbreaks is an important public health strategy to reduce the associated mortality, particularly when new strains emerge and in younger people.

在日本大流行的头三年,COVID-19患者的特定县医院床位利用率和住院死亡率。
背景:我们研究了日本大流行前三年covid -19特定县的床位利用率与住院死亡率之间的关系。方法:这项全国性研究纳入了2020年5月1日至2022年11月30日期间住院的58,175名来自日本COVID-19登记处的COVID-19患者。根据确诊时各县每周covid -19特定床位使用率,将患者分为< 25%、25% ~ < 50%、50% ~ < 75%和≥75% 4组。比值比(ORs)通过拟合一个广义线性混合模型来估计,该模型以地区为随机截距,并调整协变量(年龄、性别、体重指数、吸烟和饮酒状况以及合并症)。根据年龄组、性别和大流行浪潮进行了进一步分析。结果:院内全因死亡2312例(4.0%)。全因住院死亡率随着诊断时COVID-19床位使用率的增加而增加(多变量模型OR为1.35,95%置信区间[CI]为1.19-1.54,为25%)。结论:我们的研究结果强调,在疫情爆发期间预防医院床位短缺是降低相关死亡率的重要公共卫生策略,特别是当新菌株出现时和在年轻人中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Epidemiology
Journal of Epidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
7.50
自引率
4.30%
发文量
172
审稿时长
6-12 weeks
期刊介绍: The Journal of Epidemiology is the official open access scientific journal of the Japan Epidemiological Association. The Journal publishes a broad range of original research on epidemiology as it relates to human health, and aims to promote communication among those engaged in the field of epidemiological research and those who use epidemiological findings.
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