Justice-Involved Status and In-Hospital Mortality Among Nonelderly Adults During the COVID-19 Pandemic, 2021.

Autor:	Kennedy BS; Connecticut Department of Correction, Health Services Unit, Wethersfield, Connecticut. Electronic address: byron.kennedy@ct.gov., Richeson RP; Connecticut Department of Correction, Health Services Unit, Wethersfield, Connecticut., Houde AJ; Connecticut Department of Correction, Health Services Unit, Wethersfield, Connecticut.
Jazyk:	angličtina
Zdroj:	The American journal of medicine [Am J Med] 2024 Dec; Vol. 137 (12), pp. 1216-1226. Date of Electronic Publication: 2024 Aug 12.
DOI:	10.1016/j.amjmed.2024.08.010
Abstrakt:	Objective: The purpose of this research is to examine the role of justice-involved status on in-hospital mortality among nonelderly adults during the second year of the COVID-19 pandemic. Methods: This retrospective cohort study used data from the 2021 State Inpatient Databases for 20 US states, which included discharges from general acute care hospitals among adults aged 18-64 years hospitalized for at least 24 hours. The main outcome was all-cause in-hospital mortality and the primary comparison was justice-involved status. We used logistic regression to estimate the odds ratios and 95% confidence intervals (CIs), with adjustment for sociodemographic factors, Elixhauser comorbidities, COVID-19 diagnosis, admission acuity, other clinical features, metropolitan area, and seasonality. We randomly split the data into a 50% training and 50% validation set. With the latter, we evaluated the performance of our final model. Results: The study population included 4,712,441 discharges (1.1% justice-involved; mean [SD] age 47.5 [12.8] years; 47.0% women; 63.6% White, 21.8% Black, 11.8% Hispanic, 1.8% Asian/Pacific Islander, and 1.0% American Indian/Alaska Native). Among these, 102,735 in-hospital deaths (2.2%) occurred. In the multivariate analysis, in-hospital mortality was about 40% less likely among justice-involved patients (odds ratios 0.6, 95% CI 0.5-0.7, P value <0.01). The final validated model showed excellent discrimination (area under the curve for the receiver operator characteristic 0.953, 95% CI 0.952-0.954) and good calibration (Brier score 0.014, calibration belt P value .186). Conclusions: In this cohort study, justice-involved status was independently associated with lower in-hospital mortality. Future studies should examine preadmission and postdischarge outcomes. (Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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