RISK FACTORS ASSOCIATED WITH IN-HOSPITAL DEATH IN ADULT COVID-19 PATIENTS IN KARACHI, PAKISTAN: A RETROSPECTIVE CHART REVIEW

Abstract

Objective: To describe an audit of COVID-19 related mortality in the largest Navy hospitals in Pakistan and identify the risk factors associated with in-hospital death in these patients.

Study Design: Retrospective chart review.

Place and Duration of Study: Department of Medicine, PNS Shifa Hospital, Karachi, from 1st Apr to 30th May 2020.

Methodology: All patients who died in the Intensive care unit (ICU) of PNS Shifa Hospital, Karachi during study period, and having PCR positive COVID-19 infection were included. The data recorded included basic demo-graphics (age, gender and length of stay in hospital), documentation of co-morbidities (e.g. diabetes mellitus [DM], ischemic heart disease [IHD] and other medical and surgical problems), need for mechanical ventilation and most probably cause or contributory factor to the death of the patient. Descriptive statistics were used for calculating mean and frequencies. Chi-square test was used to determine the association between variables of the study.

Results: A total of 22 cases were included. There were 21 males. The mean age was 65.7 years. Most 12 (56.5%) of the patients were more than 65 years of age. DM was the most common risk factor in 15 (69%) patients followed by hypertension 13 (59%) and IHD in 10 (45%). The hospital admission ranged from 1 to 19 days with a mean of 7.13 days. Conclusion: We identified length of stay, mechanical ventilation, age >65 years, pneumonia and DIC are the potential risk factors for in-hospital mortality in severely ill COVID-19 patients. This audit can guide the clinicians working in resource constrained areas, in making decision regarding hospital admission for the high-risk cases.