Mortality Prediction of COVID-19 in Hospitalized Patients Using the 2020 Diagnosis Procedure Combination Administrative Database of Japan
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- Nojiri Shuko
- Medical Technology Innovation Center, Juntendo University, Japan Clinical Research and Trial Center, Juntendo University, Japan Clinical Translational Science, Juntendo University Graduate School of Medicine, Japan
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- Irie Yoshiki
- Clinical Research and Trial Center, Juntendo University, Japan Department of Information and Computer Technology, Graduate School of Engineering, Tokyo University of Science, Japan
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- Kanamori Rie
- Clinical Translational Science, Juntendo University Graduate School of Medicine, Japan
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- Naito Toshio
- Department of General Medicine, Juntendo University School of Medicine, Japan
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- Nishizaki Yuji
- Medical Technology Innovation Center, Juntendo University, Japan Clinical Translational Science, Juntendo University Graduate School of Medicine, Japan Department of General Medicine, Juntendo University School of Medicine, Japan Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Japan Division of Medical Education, Juntendo University School of Medicine, Japan
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説明
<p>Objectives Numerous people have died from coronavirus disease 2019 (COVID-19) infection. Identifying crucial predictive biomarkers of disease mortality is critical to support decision-making and logistic planning in healthcare systems. This study investigated the association between mortality and medical factors and prescription records in 2020 in Japan, where COVID-19 prevalence and mortality remain relatively low. </p><p>Methods This retrospective cohort study analyzed anonymous administrative data from the Diagnosis Procedure Combination (DPC) database in Japan. </p><p>Results A total of 22,795 patients were treated in DPC hospitals in 2020 in Japan, and of these, 5,980 patients over 50 years old were hospitalized, with 299 (5.0%) dying. There were 2,399 severe patients among 11,440 total hospitalized patients (all ages). The results of a logistic model analysis revealed that an older age, male sex, Parkinson's disease, cerebrovascular diseases, and chronic kidney diseases were risk factors for mortality. A machine learning analysis identified an older age, male sex (mortality), pneumonia, drugs for acid-related disorders, analgesics, anesthesia, upper respiratory tract disease, drugs for functional gastrointestinal disorders, drugs for obstructive airway diseases, topical products for joint and muscular pain, diabetes, lipid-modifying agents, calcium channel blockers, drugs for diabetes, and agents acting on the renin-angiotensin system as risk factors for a severe status. </p><p>Conclusions This COVID-19 mortality risk tool is a well-calibrated and accurate model for predicting mortality risk among hospitalized patients with COVID-19 in Japan, which is characterized by a relatively low COVID-19 prevalence, aging society, and high population density. This COVID-19 mortality prediction model can assist in resource utilization and patient and caregiver education and be useful as a risk stratification instrument for future research trials. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 62 (2), 201-213, 2023-01-15
一般社団法人 日本内科学会