Icu covid-19 outcomes among race and ethnicity in hawai'i

SESSION TITLE: Cultural Diversity Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Studies have shown that racial and ethnic minorities are disproportionately affected by COVID-19, with higher rates of hospitalization and in-hospital mortality. Hospital-based patient care can provide valuable insights into patterns of healthcare delivery and utilization among different populations. To determine factors that affect healthcare delivery and utilization in Hawaii during the COVID-19 pandemic, we analyzed data on intensive care unit (ICU) outcomes according to race and ethnicity from a major tertiary care hospital. METHODS: This is an observational study of patients seeking care at the primary adult tertiary care hospital for the state of Hawaii (Queen’s Health System) between February 2020 and August 2022. We investigated the association of hospital fatality rates (HFR) in the ICU among self-reported race and ethnicity groups. SARS-CoV-2 infection was confirmed at admission. HFR was assessed by dividing the deaths per all SARS-CoV-2 positive hospitalizations. Races/ethnicities were investigated by subdividing the study population into White, Native Hawaiian, Pacific Islander (PI), Filipino, Japanese, Chinese, other Asian (primarily Southeast Asians), and Black consistent with the Hawaii State Department of Health classifications. RESULTS: In this study, a total of 5,900 medical records were included. Duplicated encounters and related data issues reduced the study population to 5,494 medical records. This study showed that other Asians (62.50) had the highest ICU-associated HFR, followed by Chinese (61.29), Filipino (42.86), Hawaiian (41.18), PI (40.48), Japanese (33.33), and White (30.56). In contrast, Japanese patients had the highest HFR in the non-ICU setting (10.42), followed by other Asians (9.42), Chinese (8.4), Filipinos (7.81), White (5.9), Hawaiian (5.83), and PI (5.44). This study showed Sequential Organ Failure Assessment (SOFA) score upon admission was highest in PIs and Filipinos, and a linear association showing proportional increments of HFR with increasing SOFA scores (R2=0.944, P<0.001) in predicting HFR. Another significant finding of this study was that HFR increases exponentially with age among all races/ethnicities. The number of COVID-19 vaccinations had a significant relationship with lower HFR in both ICU and non-ICU settings regardless of race/ethnicity. CONCLUSIONS: Among SARS-CoV-2 confirmed hospitalizations, minorities had higher HFR in both ICU and non-ICU settings. Increased SOFA scores also predicted increased HFR in all race/ethnic groups and COVID vaccination status was strongly associated with decreasing HFR. CLINICAL IMPLICATIONS: Understanding the exact factors that contribute to increased HFR in minorities in and out of the ICU needs to be elucidated further. DISCLOSURES: No relevant relationships by Dominic Chow No relevant relationships by Gehan Devendra No relevant relationships by Maan Gozun No relevant relationships by F. DeWolfe Miller No relevant relationships by Juwon Park