Survival Analysis of Hospital Length of Stay of COVID-19 Patients in Ilam Province, Iran: A Retrospective Cross-Sectional Study

Abstract

Knowledge of the length of hospitalization of patients infected with coronavirus disease 2019 (COVID-19), its characteristics, and its related factors creates a better understanding of the impact of medical interventions and hospital capacities. Iran is one of the countries with the most deaths in the world (146,321 total deaths; 5 September 2023) and ranks first among the countries of the Middle East and the EMRO. Analysis of confirmed COVID-19 patients’ hospital length of stay in Ilam Province can be informative for decision making in other provinces of Iran. This study was conducted to analyze the survival of COVID-19 patients and the factors associated with COVID-19 deaths in the hospitals of Ilam Province. This is a retrospective cross-sectional study. Data from confirmed COVID-19 cases in Ilam Province were obtained from the SIB system in 2019. The sample size was 774 COVID-19-positive patients from Ilam Province. Measuring survival and risk probabilities in one-week intervals was performed using Cox regression. Most patients were male (55.4%) and 55.3% were over 45 years old. Of the 774 patients, 87 (11.2%) died during the study period. The mean hospital length of stay was 5.14 days. The median survival time with a 95% confidence interval was four days. The probability of survival of patients was 80%, 70%, and 38% for 10, 20, and 30 days of hospital stay, respectively. There was a significant relationship between the survival time of patients with age, history of chronic lung diseases, history of diabetes, history of heart diseases, and hospitalization in ICU (p < 0.05). The risk of dying due to COVID-19 disease was higher among men, older age groups, and patients with a history of chronic lung diseases, diabetes, and heart disease. According to the results, taking preventive measures for elderly patients and those with underlying conditions to prevent the infection of COVID-19 patients is of potential interest. Efficiency in the management of hospital beds should also be considered.