Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area Safiya Richardson, MD, MPH; Jamie S. Hirsch, MD, MA, MSB; Mangala Narasimhan, DO; James M. Crawford, MD, PhD; Thomas McGinn, MD, MPH; Karina W. Davidson, PhD, MASc; and the Northwell COVID-19 Research Consortium

IMPORTANCE There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19).

OBJECTIVE To describe the clinical characteristics and outcomes of patients with COVID-19 hospitalized in a US health care system.

DESIGN, SETTING, AND PARTICIPANTS Case series of patients with COVID-19 admitted to 12 hospitals in New York City, Long Island, and Westchester County, New York, within the Northwell Health system. The study included all sequentially hospitalized patients between March 1, 2020, and April 4, 2020, inclusive of these dates.

EXPOSURES Confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample among patients requiring admission.

MAIN OUTCOMES AND MEASURES Clinical outcomes during hospitalization, such as invasive mechanical ventilation, kidney replacement therapy, and death. Demographics, baseline comorbidities, presenting vital signs, and test results were also collected.

RESULTS A total of 5700 patients were included (median age, 63 years [interquartile range {IQR}, 52-75; range, 0-107 years]; 39.7% female). The most common comorbidities were hypertension (3026; 56.6%), obesity (1737; 41.7%), and diabetes (1808; 33.8%). At triage, 30.7% of patients were febrile, 17.3% had a respiratory rate greater than 24 breaths/minute, and 27.8% received supplemental oxygen. The rate of respiratory virus co-infection was 2.1%. Outcomes were assessed for 2634 patients who were discharged or had died at the study end point. During hospitalization, 373 patients (14.2%) (median age, 68 years [IQR, 56-78]; 33.5% female) were treated in the intensive care unit care, 320 (12.2%) received invasive mechanical ventilation, 81 (3.2%) were treated with kidney replacement therapy, and 553 (21%) died. As of April 4, 2020, for patients requiring mechanical ventilation (n = 1151, 20.2%), 38 (3.3%) were discharged alive, 282 (24.5%) died, and 831 (72.2%) remained in hospital. The median postdischarge follow-up time was 4.4 days (IQR, 2.2-9.3). A total of 45 patients (2.2%) were readmitted during the study period. The median time to readmission was 3 days (IQR, 1.0-4.5) for readmitted patients. Among the 3066 patients who remained hospitalized at the final study follow-up date (median age, 65 years [IQR, 54-75]), the median follow-up at time of censoring was 4.5 days (IQR, 2.4-8.1).

CONCLUSIONS AND RELEVANCE This case series provides characteristics and early outcomes of sequentially hospitalized patients with confirmed COVID-19 in the New York City area.

JAMA. 2020;323(20):2052-2059. doi:10.1001/jama.2020.6775 Published online April 22, 2020. Corrected on April 24, 2020.

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Author Affiliations: Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York (Richardson, Hirsch, McGinn, Davidson); Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York (Richardson, Hirsch, Narasimhan, Crawford, McGinn, Davidson); Department of Information Services, Northwell Health, New Hyde Park, New York (Hirsch).

Group Information: The Northwell COVID-19 Research Consortium authors and investigators appear at the end of the article.

Corresponding Author: Karina W. Davidson, PhD, Northwell Health, 130 E 59th St, Ste 14C, New York, NY 10022 ([email protected]).

Research

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T he first confirmed case of coronavirus disease 2019(COVID-19) in the US was reported from WashingtonState on January 31, 2020.1 Soon after, Washington and California reported outbreaks, and cases in the US have now exceeded total cases reported in both Italy and China.2 The rate of infections in New York, with its high population density, has exceeded every other state, and, as of April 20, 2020, it has more than 30% of all of the US cases.3

Limited information has been available to describe the presenting characteristics and outcomes of US patients requiring hospitalization with this illness. In a retrospective cohort study from China, hospitalized patients were pre- dominantly men with a median age of 56 years; 26% required intensive care unit (ICU) care, and there was a 28% mortality rate.4 However, there are significant differences between China and the US in population demographics,5 smoking rates,6 and prevalence of comorbidities.7

This study describes the demographics, baseline comor- bidities, presenting clinical tests, and outcomes of the first se- quentially hospitalized patients with COVID-19 from an aca- demic health care system in New York.

Methods The study was conducted at hospitals in Northwell Health, the largest academic health system in New York, serving ap- proximately 11 million persons in Long Island, Westchester County, and New York City. The Northwell Health institutional review board approved this case series as minimal-risk re- search using data collected for routine clinical practice and waived the requirement for informed consent. All consecutive patients who were sufficiently medically ill to require hospital admission with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample were included. Patients were admitted to any of 12 Northwell Health acute care hospitals between March 1, 2020, and April 4, 2020, inclusive of those dates. Clinical outcomes were moni- tored until April 4, 2020, the final date of follow-up.

Data were collected from the enterprise electronic health record (Sunrise Clinical Manager; Allscripts) report- ing database, and all analyses were performed using version 3.5.2 of the R programming language (R Project for Statisti- cal Computing; R Foundation). Patients were considered to have confirmed infection if the initial test result was posi- tive or if it was negative but repeat testing was positive. Repeat tests were performed on inpatients during hospital- ization shortly after initial test results were available if there was a high clinical pretest probability of COVID-19 or if the initial negative test result had been judged likely to be a false-negative due to poor sample collection. Transfers from one in-system hospital to another were merged and consid- ered as a single visit. There were no transfers into or out of the system. For patients with a readmission during the study period, data from the first admission are presented.

Data collected included patient demographic informa- tion, comorbidities, home medications, triage vitals, initial

laboratory tests, initial electrocardiogram results, diagnoses during the hospital course, inpatient medications, treatments (including invasive mechanic al ventilation and kidney replacement therapy), and outcomes (including length of stay, discharge, readmission, and mortality). Demographics, baseline comorbidities, and presenting clinical studies were available for all admitted patients. All clinical outcomes are presented for patients who completed their hospital course at study end (discharged alive or dead). Clinical outcomes avail- able for those in hospital at the study end point are pre- sented, including invasive mechanical ventilation, ICU care, kidney replacement therapy, and length of stay in hospital. Outcomes such as discharge disposition and readmission were not available for patients in hospital at study end because they had not completed their hospital course. Home medications were reported based on the admission medica- tion reconciliation by the inpatient-accepting physician because this is the most reliable record of home medications. Final reconciliation has been delayed until discharge during the current pandemic. Home medications are therefore pre- sented only for patients who have completed their hospital course to ensure accuracy.

Race and ethnicity data were collected by self-report in prespecified fixed categories. These data were included as study variables to characterize admitted patients. Initial laboratory testing was defined as the first test results avail- able, typically within 24 hours of admission. For initial labo- ratory testing and clinical studies for which not all patients had values, percentages of total patients with completed tests are shown. The Charlson Comorbidity Index predicts 10-year survival in patients with multiple comorbidities and was used as a measure of total comorbidity burden.8 The lowest score of 0 corresponds to a 98% estimated 10-year survival rate. Increasing age in decades older than age 50 years and comorbidities, including congestive heart disease and cancer, increase the total score and decrease the esti- mated 10-year survival. A total of 16 comorbidities are included. A score of 7 points and above corresponds to a 0% estimated 10-year survival rate. Acute kidney injury was identified as an increase in serum creatinine by 0.3 mg/dL or more (≥26.5 μmol/L) within 48 hours or an increase in

Key Points Question What are the characteristics, clinical presentation, and outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19) in the US?

Findings In this case series that included 5700 patients hospitalized with COVID-19 in the New York City area, the most common comorbidities were hypertension, obesity, and diabetes. Among patients who were discharged or died (n = 2634), 14.2% were treated in the intensive care unit, 12.2% received invasive mechanical ventilation, 3.2% were treated with kidney replacement therapy, and 21% died.

Meaning This study provides characteristics and early outcomes of patients hospitalized with COVID-19 in the New York City area.

Clinical Characteristics, Comorbidities, and Outcomes Among Patients With COVID-19 Hospitalized in the NYC Area Original Investigation Research

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serum creatinine to 1.5 times or more baseline within the prior 7 days compared with the preceding 1 year of data in acute care medical records. This was based on the Kidney Disease: Improving Global Outcomes (KDIGO) definition.9

Acute hepatic injury was defined as an elevation in aspar- tate aminotransferase or alanine aminotransferase of more than 15 times the upper limit of normal.

Results A total of 5700 patients were included (median age, 63 years [interquartile range {IQR}, 52-75; range, 0-107 years]; 39.7% female) (Table 1). The median time to obtain polymerase chain reaction testing results was 15.4 hours (IQR, 7.8-24.3). The most common comorbidities were hypertension (3026, 56.6%), obesity (1737, 41.7%), and diabetes (1808, 33.8%). The median score on the Charlson Comorbidity Index was 4 points (IQR, 2-6), which corresponds to a 53% estimated 10-year survival and reflects a significant comorbidity bur- den for these patients. At triage, 1734 patients (30.7%) were febrile, 986 (17.3%) had a respiratory rate greater than 24 breaths/minute, and 1584 (27.8%) received supplemental oxygen (Table 2 and Table 3). The first test for COVID-19 was positive in 5517 patients (96.8%), while 183 patients (3.2%) had a negative first test and positive repeat test. The rate of

Table 1. Baseline Characteristics of Patients Hospitalized With COVID-19

No. (%) Demographic information

Total No. 5700

Age, median (IQR) [range], y 63 (52-75) [0-107]

Sex

Female 2263 (39.7)

Male 3437 (60.3)

Racea

No. 5441

African American 1230 (22.6)

Asian 473 (8.7)

White 2164 (39.8)

Other/multiracial 1574 (28.9)

Ethnicitya

No. 5341

Hispanic 1230 (23)

Non-Hispanic 4111 (77)

Preferred language non-English 1054 (18.5)

Insurance

Commercial 1885 (33.1)

Medicaid 1210 (21.2)

Medicare 2415 (42.4)

Self-pay 95 (1.7)

Otherb 95 (1.7)

Comorbidities

Total No. 5700

Cancer 320 (6)

Cardiovascular disease

Hypertension 3026 (56.6)

Coronary artery disease 595 (11.1)

Congestive heart failure 371 (6.9)

Chronic respiratory disease

Asthma 479 (9)

Chronic obstructive pulmonary disease 287 (5.4)

Obstructive sleep apnea 154 (2.9)

Immunosuppression

HIV 43 (0.8)

History of solid organ transplant 55 (1)

Kidney disease

Chronicc 268 (5)

End-staged 186 (3.5)

Liver disease

Cirrhosis 19 (0.4)

Chronic

Hepatitis B 8 (0.1)

Hepatitis C 3 (0.1)

Metabolic disease

Obesity (BMI ≥30) 1737 (41.7)

No. 4170

Morbid obesity (BMI ≥35) 791 (19.0)

No. 4170

Diabetese 1808 (33.8)

(continued)

Table 1. Baseline Characteristics of Patients Hospitalized With COVID-19 (continued)

No. (%) Never smoker 3009 (84.4)

No. 3567

Comorbiditiesf

None 350 (6.1)

1 359 (6.3)

>1 4991 (88)

Total, median (IQR) 4 (2-8)

Charlson Comorbidity Index score, median (IQR)g 4 (2-6)

Abbreviations: BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); COVID-19, coronavirus disease 2019; IQR, interquartile range. a Race and ethnicity data were collected by self-report in prespecified fixed

categories. b Other insurance includes military, union, and workers’ compensation. c Assessed based on a diagnosis of chronic kidney disease in medical history by

International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) coding.

d Assessed based on a diagnosis of end-stage kidney disease in medical history by ICD-10 coding.

e Assessed based on a diagnosis of diabetes mellitus and includes diet-controlled and non–insulin-dependent diabetes.

f Comorbidities listed here are defined as medical diagnoses included in medical history by ICD-10 coding. These include, but are not limited to, those presented in the table.

g Charlson Comorbidity Index predicts the 10-year mortality for a patient based on age and a number of serious comorbid conditions, such as congestive heart failure or cancer. Scores are summed to provide a total score to predict mortality. The median score of 4 corresponds to a 53% estimated 10-year survival and reflects a significant comorbidity burden for these patients.

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co-infection with another respiratory virus for those tested was 2.1% (42/1996). Discharge disposition by 10-year age intervals of all 5700 study patients is included in Table 4. Length of stay for those who died, were discharged alive, and remained in hospital are presented as well. Among the 3066 patients who remained hospitalized at the final study

follow-up date (median age, 65 years [IQR 54-75]), the median follow-up at time of censoring was 4.5 days (IQR, 2.4-8.1). Mortality was 0% (0/20) for male and female patients younger than 20 years. Mortality rates were higher for male compared with female patients at every 10-year age interval older than 20 years.

Table 2. Presentation Vitals and Laboratory Results of Patients Hospitalized With COVID-19

Triage vitalsa No. (%) No. Reference ranges Temperature >38 °C 1734 (30.7)

5644 Temperature, median (IQR), °C 37.5 (36.9-38.3)

Oxygen saturation

<90% 1162 (20.4) 5693

% Median (IQR) 95 (91-97)

Received supplemental oxygen at triage 1584 (27.8) 5693

Respiratory rate >24 breaths/min 986 (17.3) 5695

Heart rate

≥100 beats/min 2457 (43.1) 5696

Median (IQR) 97 (85-110)

Initial laboratory measures, median (IQR)a

White blood cell count, ×109/L 7.0 (5.2-9.5) 5680 3.8-10.5

Absolute count, ×109/L

Neutrophil 5.3 (3.7-7.7) 5645 1.8-7.4

Lymphocyte 0.88 (0.6-1.2) 5645 1.0-3.3

Lymphocyte, <1000 ×109/L 3387 (60)

Sodium, mmol/L 136 (133-138) 5645 135-145

Aspartate aminotransferase, U/L 46 (31-71) 5586 10-40

Aspartate aminotransferase >40 U/L 3263 (58.4)

Alanine aminotransferase, U/L 33 (21-55) 5587 10-45

Alanine aminotransferase >60 U/L 2176 (39.0)

Creatine kinase, U/L 171 (84-397) 2527 25-200

Venous lactate, mmol/L 1.5 (1.1-2.1) 2508 0.7-2.0

Troponin above test-specific upper limit of normalb

801 (22.6) 3533

Brain-type natriuretic peptide, pg/mL

385.5 (106-1996.8) 1818 0-99

Procalcitonin, ng/mL 0.2 (0.1-0.6) 4138 0.02-0.10

D-dimer, ng/mL 438 (262-872) 3169 0-229

Ferritin, ng/mL 798 (411-1515) 4344 15-400

C-reactive protein, mg/dL 13.0 (6.4-26.9) 4517 0.0-0.40

Lactate dehydrogenase, U/L 404.0 (300-551.5) 4003 50-242

Admission studiesa

ECG, QTC >500c 260 (6.1) 4250 <400

Respiratory viral panel, positive for non–COVID-19 respiratory virus

42 (2.1) 1996

Chlamydia pneumoniae 2 (4.8)

Coronavirus (non–COVID-19) 7 (16.7)

Entero/rhinovirus 22 (52.4)

Human metapneumovirus 2 (4.8)

Influenza A 1 (2.4)

Mycoplasma pneumoniae 1 (2.4)

Parainfluenza 3 3 (7.1)

Respiratory syncytial virus 4 (9.5)

Length of stay for patients in hospital at study end point, median (IQR), d

4.5 (2.4-8.1)

No. 3066

Abbreviations: COVID-19, coronavirus disease 2019; ECG, electrocardiogram; IQR, interquartile range; QTC, corrected QT interval.

SI conversion factors: To convert alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, creatinine kinase, and lactate dehydrogenase to μkat/L, multiply by 0.0167. a Triage vital signs, initial laboratory

measures, and admission studies were selected to be included here based on relevance to the characterization of patients with COVID-19.

b Troponin I; troponin T; and troponin T, high sensitivity are used at about equal frequency across these institutions. For simplicity, we present the number and percentage of test results that were above the upper limit of normal for the individual references ranges for these 3 tests.

c QTC resulted from the automated ECG reading.

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Outcomes for Patients Who Were Discharged or Died Among the 2634 patients who were discharged or had died at the study end point, during hospitalization, 373 (14.2%) were treated in the ICU, 320 (12.2%) received invasive mechanical ventilation, 81 (3.2%) were treated with kidney replacement therapy, and 553 (21%) died (Table 5). As of April 4, 2020, for patients requiring mechanical ventilation (n = 1151, 20.2%), 38 (3.3%) were discharged alive, 282 (24.5%) died, and 831 (72.2%) remained in hospital. Mortal- ity rates for those who received mechanical ventilation in the 18-to-65 and older-than-65 age groups were 76.4% and 97.2%, respectively. Mortality rates for those in the 18-to-65 and older-than-65 age groups who did not receive mechani- cal ventilation were 1.98% and 26.6%, respectively. There were no deaths in the younger-than-18 age group. The over- all length of stay was 4.1 days (IQR, 2.3-6.8). The median postdischarge follow-up time was 4.4 days (IQR, 2.2-9.3).

A total of 45 patients (2.2%) were readmitted during the study period. The median time to readmission was 3 days (IQR, 1.0-4.5). Of the patients who were discharged or had died at the study end point, 436 (16.6%) were younger than age 50 with a score of 0 on the Charlson Comorbidity Index, of whom 9 died.

Outcomes by Age and Risk Factors For both patients discharged alive and those who died, the percentage of patients who were treated in the ICU or received invasive mechanical ventilation was increased for the 18-to-65 age group compared with the older-than-65 years age group (Table 5). For patients discharged alive, the lowest absolute lymphocyte count during hospital course was lower for progressively older age groups. For patients discharged alive, the readmission rates and the percentage of patients discharged to a facility (such as a nursing home or

Table 3. Hospital Characteristics and Admission Rates

Hospitala

No. (%)

Study admissions (N = 5700)

Acute beds (March occupancy), meanb

Annual emergency department visits (% admitted)

North Shore University Hospital 1073 (18.8) 637 (92) 51 000 (34)

Long Island Jewish Medical Center 1151 (20.2) 517 (91) 66 000 (28)

Staten Island University Hospital 674 (11.9) 466 (85) 93 000 (25)

Lenox Hill Hospital 558 (9.8) 324 (75) 40 000 (29)

Southside Hospital 445 (7.8) 270 (86) 59 000 (18)

Huntington Hospital 359 (6.3) 231 (81) 40 000 (22)

Long Island Jewish Forest Hills 608 (10.7) 187 (86) 42 000 (21)

Long Island Jewish Valley Stream 355 (6.2) 180 (75) 31 000 (23)

Plainview Hospital 231 (4.1) 156 (70) 24 000 (29)

Cohen Children’s Medical Center 42 (0.7) 111 (78) 48 000 (14)

Glen Cove Hospital, nonteaching 117 (2.1) 66 (78) 15 000 (20)

Syosset Hospital 87 (1.5) 55 (70) 12 000 (21)

a Teaching hospital unless otherwise noted.

b More than 1200 acute beds were added across the system during the month of March 2020.

Table 4. Discharge Disposition by 10-Year Age Intervals of Patients Hospitalized With COVID-19

Patients discharged alive or dead at study end point

Patients in hospital at study end point

Died, No./No. (%) Length of stay among those who died, median (IQR), da

Discharged alive, No./No. (%) Length of stay among those discharged alive, median (IQR), da No./No. (%)

Length of stay, median (IQR), daMale Female Male Female

Age intervals, y

0-9 0/13 0/13 NA 13/13 (100) 13/13 (100) 2.0 (1.7-2.7) 7/33 (21.2) 4.3 (3.1-12.5)

10-19 0/1 0/7 NA 1/1 (100) 7/7 (100) 1.8 (1.0-3.1) 9/17 (52.9) 3.3 (2.8-4.3)

20-29 3/42 (7.1) 1/55 (1.8) 4.0 (0.8-7.4) 39/42 (92.9) 54/55 (98.2) 2.5 (1.8-4.0) 52/149 (34.9) 3.2 (1.9-6.4)

30-39 6/130 (4.6) 2/81 (2.5) 2.8 (2.4-3.6) 124/130 (95.4) 79/81 (97.5) 3.7 (2.0-5.8) 142/353 (40.2) 5.1 (2.5-9.0)

40-49 19/233 (8.2) 3/119 (2.5) 5.6 (3.0-8.4) 214/233 (91.8) 116/119 (97.5) 3.9 (2.3-6.1) 319/671 (47.5) 4.9 (2.9-8.2)

50-59 40/327 (12.2) 13/188 (6.9) 5.9 (3.1-9.5) 287/327 (87.8) 175/188 (93.1) 3.8 (2.5-6.7) 594/1109 (53.6) 4.9 (2.8-8.0)

60-69 56/300 (18.7) 28/233 (12.0) 5.7 (2.6-8.2) 244/300 (81.3) 205/233 (88.0) 4.3 (2.5-6.8) 771/1304 (59.1) 5.0 (2.4-8.2)

70-79 91/254 (35.8) 54/197 (27.4) 5.0 (2.7-7.8) 163/254 (64.2) 143/197 (72.6) 4.6 (2.8-7.8) 697/1148 (60.7) 4.5 (2.3-8.2)

80-89 94/155 (60.6) 76/158 (48.1) 3.9 (2.1-6.5) 61/155 (39.4) 82/158 (51.9) 4.4 (2.7-7.7) 369/682 (54.1) 4.1 (2.1-7.4)

≥90 28/44 (63.6) 39/84 (46.4) 3.0 (0.7-5.5) 16/44 (36.4) 45/84 (53.6) 4.8 (2.8-8.4) 106/234 (45.3) 3.2 (1.5-6.4)

Abbreviations: COVID-19, coronavirus disease 2019; IQR, interquartile range; NA, not applicable. a Length of stay begins with admission time and ends with discharge time, time

at death, or midnight on the last day of data collection for the study. It does not include time in the emergency department.

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rehabilitation), as opposed to home, increased for progres- sively older age groups.

Of the patients who died, those with diabetes were more likely to have received invasive mechanical ventilation or care in the ICU compared with those who did not have diabe- tes (eTable 1 in the Supplement). Of the patients who died, those with hypertension were less likely to have received invasive mechanical ventilation or care in the ICU compared with those without hypertension. The percentage of patients

who developed acute kidney injury was increased in the sub- groups with diabetes compared with subgroups without those conditions.

Angiotensin-Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker Use Home medication reconciliation information was available for 2411 (92%) of the 2634 patients who were discharged or who died by the study end. Of these 2411 patients, 189 (7.8%) were taking

Table 5. Clinical Measures and Outcomes for Patients Discharged Alive, Dead, and In Hospital at Study End Point by Age

Clinical measure

Total discharged alive and dead patients (N = 2634)

Discharged alive Died In hospital <18 y (n = 32)

18-65 y (n = 1373)

>65 y (n = 676)

<18 y (n = 0)

18-65 y (n = 134)

>65 y (n = 419)

<18 (n = 14)

18-65 (n = 1565)

>65 (n = 1487)

Invasive mechanical ventilationa

320 (12.2) 0 33 (2.4) 5 (0.7) NA 107 (79.9) 175 (41.8) 4 (28.6) 449 (28.7) 378 (25.4)

ICU care 373 (14.2) 2 (6.3) 62 (4.5) 18 (2.7) NA 109 (81.3) 182 (43.4) 5 (35.7) 490 (31.3) 413 (27.8)

Absolute lymphocyte count at nadir, median (IQR), ×109/L (reference range, 1.0-3.3)

0.8 (0.5-1.14) 2.3 (1.2-5.0)

0.9 (0.7-1.2)

0.8 (0.5-1.1)

NA 0.5 (0.3-0.8)

0.5 (0.3-0.8)

2.0 (1.0-3.5)

0.7 (0.5-1.0)

0.6 (0.4-0.9)

No. 2626 32 1371 675 134 417 3 1564 1486

Acute kidney injuryb

523 (22.2) 1 (11.1) 93 (7.5) 82 (13.1) NA 98 (83.8) 249 (68.4) 2 (14.3) 388 (25.5) 457 (34.5)

No. 2351 8 1237 624 117 364 8 1400 1326

Kidney replacement therapy

81 (3.2) 0 2 (0.1) 1 (0.2) NA 43 (35.0) 35 (8.8) 0 82 (5.4) 62 (4.4)

Acute hepatic injuryc

56 (2.1) 0 3 (0.2) 0 NA 25 (18.7) 28 (6.7) 0 21 (1.3) 12 (0.8)

No. 1371 675 134 417 3 1564 1486

Outcomes

Length of stay, median (IQR), dd

4.1 (2.3-6.8) 2.0 (1.7-2.8)

3.8 (2.3-6.2)

4.5 (2.7-7.2)

NA 5.5 (2.9-8.4)

4.4 (2.1-7.1)

4.0 (2.4-6.2)

4.8 (2.5-8.1)

4.4 (2.3-8.0)

Discharged alive 3.9 (2.4-6.7)

Died 4.8 (2.3-7.4)

Died 553 (21) NA NA NA NA NA NA NA NA N/A

Died, of those who did not receive mechanical ventilation

271/2314 (11.7) NA NA NA NA NA NA NA NA

Died, of those who did receive mechanical ventilation

282/320 (88.1)

Readmittede 45 (2.2) 1 (3.1) 22 (1.6) 22 (3.3) NA NA NA NA NA NA

Discharge disposition of 2081 patients discharged alive

No. 2081

Home 1959 (94.1) 32 (100) 1345 (98.0) 582 (86.1) NA NA NA NA NA NA

Facilities (ie, nursing home, rehab)

122 (5.9) 0 28 (2

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