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Keene, Adam B.; Admon, Andrew J.; Brenner, Samantha K.; Gupta, Shruti; Lazarous, Deepa; Leaf, David E.; Gershengorn, Hayley B.; Walther, Carl P.; Anumudu, Samaya J.; Arunthamakun, Justin; Kopecky, Kathleen F.; Milligan, Gregory P.; McCullough, Peter A.; Nguyen, Thuy-Duyen; Shaefi, Shahzad; O’Gara, Brian P.; Krajewski, Megan L.; Baskin, Sean M.; Shankar, Sidharth; Valencia, Juan D.; Pannu, Ameeka; Hayes, Margaret M.; Grandin, E. Wilson; Waikar, Sushrut S.; [...]

Association of Surge Conditions with Mortality Among Critically Ill Patients with COVID-19

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  • Medientyp: E-Artikel
  • Titel: Association of Surge Conditions with Mortality Among Critically Ill Patients with COVID-19
  • Beteiligte: Keene, Adam B.; Admon, Andrew J.; Brenner, Samantha K.; Gupta, Shruti; Lazarous, Deepa; Leaf, David E.; Gershengorn, Hayley B.; Walther, Carl P.; Anumudu, Samaya J.; Arunthamakun, Justin; Kopecky, Kathleen F.; Milligan, Gregory P.; McCullough, Peter A.; Nguyen, Thuy-Duyen; Shaefi, Shahzad; O’Gara, Brian P.; Krajewski, Megan L.; Baskin, Sean M.; Shankar, Sidharth; Valencia, Juan D.; Pannu, Ameeka; Hayes, Margaret M.; Grandin, E. Wilson; Waikar, Sushrut S.; [...]
  • Erschienen: SAGE Publications, 2022
  • Erschienen in: Journal of Intensive Care Medicine
  • Sprache: Englisch
  • DOI: 10.1177/08850666211067509
  • ISSN: 0885-0666; 1525-1489
  • Schlagwörter: Critical Care and Intensive Care Medicine
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec><jats:title>Objective</jats:title><jats:p> To determine whether surge conditions were associated with increased mortality. </jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p> Multicenter cohort study. </jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p> U.S. ICUs participating in STOP-COVID. </jats:p></jats:sec><jats:sec><jats:title>Patients</jats:title><jats:p> Consecutive adults with COVID-19 admitted to participating ICUs between March 4 and July 1, 2020. </jats:p></jats:sec><jats:sec><jats:title>Interventions</jats:title><jats:p> None </jats:p></jats:sec><jats:sec><jats:title>Measurements and Main Results</jats:title><jats:p> The main outcome was 28-day in-hospital mortality. To assess the association between admission to an ICU during a surge period and mortality, we used two different strategies: (1) an inverse probability weighted difference-in-differences model limited to appropriately matched surge and non-surge patients and (2) a meta-regression of 50 multivariable difference-in-differences models (each based on sets of randomly matched surge- and non-surge hospitals). In the first analysis, we considered a single surge period for the cohort (March 23 – May 6). In the second, each surge hospital had its own surge period (which was compared to the same time periods in matched non-surge hospitals). Our cohort consisted of 4342 ICU patients (average age 60.8 [sd 14.8], 63.5% men) in 53 U.S. hospitals. Of these, 13 hospitals encountered surge conditions. In analysis 1, the increase in mortality seen during surge was not statistically significant (odds ratio [95% CI]: 1.30 [0.47-3.58], p = .6). In analysis 2, surge was associated with an increased odds of death (odds ratio 1.39 [95% CI, 1.34-1.43], p &lt; .001). </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Admission to an ICU with COVID-19 in a hospital that is experiencing surge conditions may be associated with an increased odds of death. Given the high incidence of COVID-19, such increases would translate into substantial excess mortality. </jats:p></jats:sec>