Hospital length of stay for COVID-19 patients: Data-driven methods for forward planning

作者：Bindu Vekaria, Christopher E. Overton, Arkadiusz Wiśniowski, Shazaad Ahmad, Andrea Aparicio-Castro, Jacob Curran-Sebastian, Jane Eddleston, Neil A. Hanley, Thomas House, Ji-Hye Kim, Wendy Olsen, María Pampaka, Lorenzo Pellis, Diego Andrés Pérez Ruiz, John Schofield, Nick Shryane, Mark Elliot · 发表于：BMC Infectious Diseases · 年份：2021 · DOI：10.1186/s12879-021-06371-6 · 被引用次数：167 · 研究领域：COVID-19 epidemiological studies、Sepsis Diagnosis and Treatment、COVID-19 Clinical Research Studies

BACKGROUND: Predicting hospital length of stay (LoS) for patients with COVID-19 infection is essential to ensure that adequate bed capacity can be provided without unnecessarily restricting care for patients with other conditions. Here, we demonstrate the utility of three complementary methods for predicting LoS using UK national- and hospital-level data. METHOD: On a national scale, relevant patients were identified from the COVID-19 Hospitalisation in England Surveillance System (CHESS) reports. An Accelerated Failure Time (AFT) survival model and a truncation corrected method (TC), both with underlying Weibull distributions, were fitted to the data to estimate LoS from hospital admission date to an outcome (death or discharge) and from hospital admission date to Intensive Care Unit (ICU) admission date. In a second approach we fit a multi-state (MS) survival model to data directly from the Manchester University NHS Foundation Trust (MFT). We develop a planning tool that uses LoS estimates from these models to predict bed occupancy. RESULTS: All methods produced similar overall estimates of LoS for overall hospital stay, given a patient is not admitted to ICU (8.4, 9.1 and 8.0 days for AFT, TC and MS, respectively). Estimates differ more significantly between the local and national level when considering ICU. National estimates for ICU LoS from AFT and TC were 12.4 and 13.4 days, whereas in local data the MS method produced estimates of 18.9 days. CONCLUSIONS: Given the com...