Yikes, 1 in 10 middle-aged hospitalizations result in death

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Federale01
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11:18p, 4/11/20
AG
According this tracking company

Quote:
The coronavirus is killing about 1 in 10 hospitalized middle-aged patients and 4 in 10 older than 85 in the United States, and is particularly lethal to men even when taking into account common chronic diseases that exacerbate risk, according to previously unpublished data from a company that aggregates real-time patient data from 1,000 hospitals and 180,000 health-care providers.

I know the hospitals are only taking the sickest of the sick right now, but even so those are pretty bad odds.

https://www.washingtonpost.com/national/health-science/medical-databases-show-1-in-10-hospitalized-middle-aged-coronavirus-patients-in-us-do-not-survive/2020/04/11/284485a2-7bfe-11ea-b6ff-597f170df8f8_story.html


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Infection_Ag11
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11:21p, 4/11/20
AG
Remember the middle-aged people generally getting admitted are those with more risk factors. Obesity, diabetes, etc. all contribute to disease severity and mortality. And as you said, those who get admitted are already more sick than an average COVID patient.

There's a huge selection bias in play here
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Federale01
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In reply to Infection_Ag11 • 11:24p, 4/11/20
AG
Thanks. Yeah, it addresses a lot of that further down in the article. It even breaks down rates by pre-existing condition and sex. They also mention they see people with kidney problems especially having trouble. Still, pretty staggering odds.
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DCAggie13y
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In reply to Federale01 • 11:56p, 4/11/20
AG
What percentage of middle aged people die who are hospitalized for the flu? I know swine flu was pretty deadly for people that required hospitalization.
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Infection_Ag11
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11:59p, 4/11/20
AG
Honestly, 1/10 isn't that bad by hospital admission standards. If you took all patients admitted to a major urban tertiary referral center at any given time and then excluded admissions for minor elective surgeries and pure workup admissions (aka only included admissions for acute disease processes) I'd wager the overall mortality of that group at those facilities would be at least 10% if not higher.

As an example, I see a lot of patients with bacteremia or fungemia (bacteria or fungus in their bloodstream). Depending on the organism and other factors, those patients have a mortality that generally ranges from 10-50%. Heart failure and COPD exacerbations, two of the most common reasons for admission, usually carry a mortality of at least 2.5-5% and that's as bread and butter as it gets.
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Federale01
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In reply to DCAggie13y • 12:03a, 4/12/20
AG
I don't know. The article wasn't addressing the flu.
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DCAggie13y
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In reply to Infection_Ag11 • 12:06a, 4/12/20
AG
Infection_Ag11 said:
Honestly, 1/10 isn't that bad by hospital admission standards. If you took all patients admitted to a major urban tertiary referral center at any given time and then excluded admissions for minor elective surgeries and pure workup admissions (aka only included admissions for acute disease processes) I'd wager the overall mortality of that group at those facilities would be at least 10% if not higher.

As an example, I see a lot of patients with bacteremia or fungemia (bacteria or fungus in their bloodstream). Depending on the organism and other factors, those patients have a mortality that generally ranges from 10-50%. Heart failure and COPD exacerbations, two of the most common reasons for admission, usually carry a mortality of at least 2.5-5% and that's as bread and butter as it gets.


Thanks. I was thinking that if you are hospitalized you are likely in really bad shape. I have a middle aged friend who was battling COVID for 2 weeks and had trouble breathing and they would not admit him to the hospital because his chest x-ray was clear. He thought he was dying but it wasn't bad enough to be hospitalized. So I'm guessing you have to be in a really bad way to actually be hospitalized.
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DCAggie13y
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In reply to Federale01 • 12:10a, 4/12/20
AG
Federale01 said:
I don't know. The article wasn't addressing the flu.


Its hard to know if these numbers mean anything without perspective or a relative comparison. It may turn out that 10% die but only .00001% require hhospitalization. Given the lack of testing and the huge numbers of asymptomatic carriers, its hard to tell if this is statistically any more deadly than a bad flu like swine flu for middle aged people. We just don't know what percentage of people who get it actually require hospitalization. I think the antibody testing will reveal a lot.
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Infection_Ag11
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In reply to DCAggie13y • 12:13a, 4/12/20
AG
Gumby said:
Infection_Ag11 said:
Honestly, 1/10 isn't that bad by hospital admission standards. If you took all patients admitted to a major urban tertiary referral center at any given time and then excluded admissions for minor elective surgeries and pure workup admissions (aka only included admissions for acute disease processes) I'd wager the overall mortality of that group at those facilities would be at least 10% if not higher.

As an example, I see a lot of patients with bacteremia or fungemia (bacteria or fungus in their bloodstream). Depending on the organism and other factors, those patients have a mortality that generally ranges from 10-50%. Heart failure and COPD exacerbations, two of the most common reasons for admission, usually carry a mortality of at least 2.5-5% and that's as bread and butter as it gets.


Thanks. I was thinking that if you are hospitalized you are likely in really bad shape. I have a middle aged friend who was battling COVID for 2 weeks and had trouble breathing and they would not admit him to the hospital because his chest x-ray was clear. He thought he was dying but it wasn't bad enough to be hospitalized. So I'm guessing you have to be in a really bad way to actually be hospitalized.


A lot of places won't admit you if you aren't hypoxic and have no evidence of end organ damage on your labs (exception being some high risk patients who are more likely to progress to severe disease).

If you're 40, not hypoxic, reasonably healthy and your labs look ok we really aren't going to do anything for you you can't do at home so why risk letting you catch something else in the hospital?
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Federale01
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In reply to DCAggie13y • 12:21a, 4/12/20
AG
Sure, I agree. The article makes sure to highlight that only the most accute patients are getting admitted and the overwhelming number of people get over the disease.

I though the statistical break down they provided was pretty interesting though.

According to this article, it looks like 3-4 percent of hospitalizations result in death for flu.

https://www.hcup-us.ahrq.gov/reports/statbriefs/sb253-Influenza-Hospitalizations-ED-Visits-2006-2016.jsp
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wargograw
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In reply to Federale01 • 12:44a, 4/12/20
Federale01 said:
Still, pretty staggering odds.
No, they're not. Stop saying that.
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Sq 17
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6:49a, 4/12/20
A few things on the stats it would be really helpful if they found something that decreased the likelihood of ending up on the hospital maybe hcq or the TB vaccination They need to find something that lowers the death rate of the hospitalized Remdesvir & Toci are both showing promise as does therapeutic plasma . If the hardworking Drs can't find an effective treatment then shelter in place is just dragging out the inevitable.

If 1 out of 10 of those needing hospitalization end up dying that is a very high death toll
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VaultingChemist
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7:05a, 4/12/20
AG
If 20% of symptomatic cases require hospitalization, and 10% of those die, then you wind up with a 2% CFR. Almost exactly what was expected based on statistics from other countries.
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Federale01
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In reply to wargograw • 9:08a, 4/12/20
AG
Based on the original thought that it really only effected people over 60, I thought it was. I guess I was completely naive to think 1 in 10 patients being hospitalized outside of the supposed danger zone dying is a bad number. I wasn't trying to be alarmist, just surprised.

Again, I understand only the sickest are going in to the hospital right now.
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jsdaltxag
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In reply to Federale01 • 10:20a, 4/12/20
Federale01 said:
Based on the original thought that it really only effected people over 60, I thought it was. I guess I was completely naive to think 1 in 10 patients being hospitalized outside of the supposed danger zone dying is a bad number. I wasn't trying to be alarmist, just surprised.

Again, I understand only the sickest are going in to the hospital right now.
If my math is correct 9 out of 10 don't die, so 90% doesn't sound bad. Shouldn't be going into the hospital unless you are in a life threatening situation anyway.
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OldArmy71
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In reply to Federale01 • 10:47a, 4/12/20
AG

Quote:
It even breaks down rates by pre-existing condition and sex.

That's behind a pay wall. Could you please quote the parts that break down those rates? Thanks!
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TMfrisco
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12:10p, 4/12/20
AG
I've been saying this for a week - if you test positive and have to go into the hospital, the death rate is unacceptably high.
Just look at Deaths versus Confirmed cases. We are closing in on 4%. I know, I know, there are a lot of unconfirmed "positives", but if you are sick enough to go to the hospital - and they may be mostly old and already sick people - the numbers are discouraging.
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SmackDaddy
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12:19p, 4/12/20
AG
No idea if he has stats to back this up...but Cuomo has been saying for weeks that 80% of positives never check into the hospital.
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