دورية أكاديمية
National outcomes and characteristics of patients admitted to Swedish intensive care units for COVID-19: A registry-based cohort study.
| العنوان: | National outcomes and characteristics of patients admitted to Swedish intensive care units for COVID-19: A registry-based cohort study. |
|---|---|
| المؤلفون: | Chew MS; From the Departments of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences (MSC, PJB, RÅ, HA), Department of Anaesthesia and Intensive Care, Vrinnevi Hospital, Norrköping, Department of Thoracic and Vascular Surgery, Medical and Health Sciences, Linköping University (LE), Department of Anaesthesia, Intensive Care and Perioperative Services, Umeå University Hospital, Umeå (RKB), Department of Public Health Reporting, Public Health Agency of Sweden (AT), Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience, Linköping University, Sweden (SM)., Blixt PJ, Åhman R, Engerström L, Andersson H, Berggren RK, Tegnell A, McIntyre S |
| المصدر: | European journal of anaesthesiology [Eur J Anaesthesiol] 2021 Apr 01; Vol. 38 (4), pp. 335-343. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins, 2009- Country of Publication: England NLM ID: 8411711 Publication Model: Print Cited Medium: Internet ISSN: 1365-2346 (Electronic) Linking ISSN: 02650215 NLM ISO Abbreviation: Eur J Anaesthesiol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Cambridge : Lippincott Williams & Wilkins, 2009- Original Publication: Oxford ; Boston : Published on behalf of the European Academy of Anaesthesiology by Blackwell Scientific, 1984-2004 |
| مواضيع طبية MeSH: | Hospital Mortality*, COVID-19/*therapy , Intensive Care Units/*statistics & numerical data , Patient Admission/*statistics & numerical data , SARS-CoV-2/*isolation & purification, Adult ; Aged ; Aged, 80 and over ; COVID-19/diagnosis ; COVID-19/mortality ; Cohort Studies ; Female ; Humans ; Italy/epidemiology ; Male ; Middle Aged ; Prospective Studies ; Registries ; Sweden/epidemiology |
| مستخلص: | Background: Mortality among patients admitted to intensive care units (ICUs) with COVID-19 is unclear due to variable follow-up periods. Few nationwide data are available to compare risk factors, treatment and outcomes of COVID-19 patients after ICU admission. Objective: To evaluate baseline characteristics, treatments and 30-day outcomes of patients admitted to Swedish ICUs with COVID-19. Design: Registry-based cohort study with prospective data collection. Setting: Admissions to Swedish ICUs from 6 March to 6 May 2020 with laboratory confirmed COVID-19 disease. Participants: Adult patients admitted to Swedish ICUs. Exposures: Baseline characteristics, intensive care treatments and organ failures. Main Outcomes and Measures: The primary outcome was 30-day all-cause mortality. A multivariable model was used to determine the independent association between potential predictor variables and death. Results: We identified 1563 patients with complete 30-day follow-up. The 30-day all-cause mortality was 26.7%. Median age was 61 [52 to 69], Simplified Acute Physiology Score III (SAPS III) was 53 [46 to 59] and 62.5% had at least one comorbidity. Median PaO2/FiO2 on admission was 97.5 [75.0 to 140.6] mmHg, 74.7% suffered from moderate-to-severe acute respiratory failure. Age, male sex [adjusted odds ratio (aOR) 1.5 (1.1 to 2.2)], SAPS III score [aOR 1.3 (1.2 to 1.4)], severe respiratory failure [aOR 3.0 (2.0 to 4.7)], specific COVID-19 pharmacotherapy [aOR 1.4 (1.0 to 1.9)] and continuous renal replacement therapy [aOR 2.1 (1.5 to 3.0)] were associated with increased mortality. Except for chronic lung disease, the presence of comorbidities was not independently associated with mortality. Conclusions: Thirty-day mortality rate in COVID-19 patients admitted to Swedish ICUs is generally lower than previously reported despite a severe degree of hypoxaemia on admission. Mortality was driven by age, baseline disease severity, the presence and degree of organ failure, rather than pre-existing comorbidities. Trial Registration No: NCT04462393. (Copyright © 2021 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.) |
| التعليقات: | Comment in: Eur J Anaesthesiol. 2021 Apr 1;38(4):331-332. (PMID: 33661825) |
| References: | Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV2 admitted to the ICUs of Lombardy Region, Italy. JAMA 2020; 323:1574–1581. Graselli G, Greco M, Zanella A, et al. Risk factors associated with mortality among patients with COVID-19 in intensive care units in Lombardy, Italy. JAMA Int Med 2020; 180:1345–1355. Gupta S, Hayek SS, Wang W, et al. Factors associated with death in critically ill patients with coronavirus disease 2019 in the US. JAMA Int Med 2020; 180:1–12. Kristinsson B, Kristinsdottir LB, Blondal AT, et al. Nationwide incidence and outcomes of patients with coronavirus disease 2019 requiring intensive care in Iceland. Crit Care Med 2020; 48:21102–21105. Haase N, Plovsing R, Christensen S, et al. Characteristics, interventions and longer-term outcomes of COVID-19 ICU patients in Denmark – a nationwide observational study. Acta Anaesth Scand 2021; 65:68–75. doi:10.1111/AAS.13701. (PMID: 10.1111/AAS.13701) Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323:1061–1069. Wu Z, McGoogan J. Characteristics and important lessons from the Coronavirus disease 2019 (COVID-2019) outbreak. Summary of a report of 72314 cases from the Chinese Centre for Disease Control and Prevention. JAMA 2020; 323:1239–1242. Yang X, Wu Y, Zhang Z, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020; 8:475–481. Bhatraju PK, Ghassemieh BJ, Nichols M, et al. COVID-19 in critically ill patients in the Seattle region — case series. N Engl J Med 2020; 382:2012–2022. Arentz M, Yim E, Klaff L, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington state. JAMA 2020; 323:1612–1614. Cummings MJ, Baldwin MR, Abrams D, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet 2020; 395:1763–1770. Mitra AR, Fergusson NA, Lloyd-Smith E, et al. Baseline characteristics and outcomes of patients with COVID-19 admitted to intensive care units in Vancouver, Canada: a case series. CMAJ 2020; 192:E694–E701. Zangrillo A, Beretta L, Scandroglio AM, et al. Characteristics, treatment, outcomes and cause of death of invasively ventilated patients with COVID-19 ARDS in Milan, Italy. Crit Care Resusc 2020; 22:200–211. Barassa H, Rello J, Tejada S, et al. SARS-CoV-2 in Spanish intensive care units: early experience with 15-day survival in Vitoria. Anesth Crit Care Pain Med 2020; 39:553–561. Yu Y, Xu D, Fu S, et al. Patients with COVID-19 in 19 ICUs in Wuhan, China: a cross-sectional study. Crit Care 2020; 24:219. Armstrong RA, Kane AD, Cook TM. Outcomes from intensive care in patients with COVID-19: a systematic review and meta-analysis of observational studies. Anaesthesia 2020; 75:1340–1349. Schmidt M, Hajage M, Demoule A, et al. Clinical characteristics and day-90 outcomes of 4244 critically ill adults with COVID-19: a prospective cohort study. Int Care Med 2020; 47:60–73. Rhodes A, Ferdinande P, Flaatten H, et al. The variability of critical care bed numbers in Europe. Int Care Med 2012; 38:1647–1653. Guideline for Swedish Intensive Care. Swedish Intensive Care Registry. Available at: https://portal.icuregswe.org/seiva/en/Rapport [Accessed 29 October 2020]. States with the most and least ICU beds. Microsoft Network. Available at: https://www.msn.com/en-us/health/medical/states-with-the-most-and-least-icu-beds/ss-BB12i2ZW [Accessed 29 October 2020]. Swedish ICU Registry, dataportal for influensa and virus infections. Swedish Intensive Care Registry. Available at: https://www.icuregswe.org/riktlinjer/riktlinjer-gallande-registrering-lista/influensaregistrering-siri/ [Accessed 9 December 2020]. Palaiodimos L, Kokkinidis DG, Weijia Li W, et al. Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism 2020; 108:154262. Tamaraa A, Tahapary DL. Obesity as a predictor for a poor prognosis of COVID-19: a systematic review. Diabetes Metab Syndr 2020; 14:655–659. Azoulay E, Fartoukh M, Darmon M, et al. Increased mortality in patients with severe SARS-CoV-2 infection admitted within seven days of disease onset. Int Care Med 2020; 46:1714–1722. Swedish ICU Registry, dataportal. Swedish Intensive Care Registry. Available at: http://portal.icuregswe.org/utdata/sv/report/prod.vardtid-medel?filter=751cd808-668c-af21-953e-6ac66992f523 [Accessed 20 October 2020]. Swedish ICU Registry, dataportal for influensa and virus infections. Swedish Intensive Care Registry. Available at: https://portal.icuregswe.org/siri/home [Accessed 20 October 2020]. Gabarre P, Dumas G, Dupont T, et al. Acute kidney injury in critically ill patients with COVID-19. Int Care Med 2020; 46:1339–1348. Cheng Y, Luo R, Wang K, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int 2020; 97:829–838. Swedish National Board of Health and Welfare. Statistics on COVID-19. Swedish National Board of Health and Welfare. Available at: https://www.socialstyrelsen.se/en/statistics-and-data/statistics/statistics-on-covid-19/ [Accessed 20 October 2020]. Guidelines of the Swedish Society of Anaesthesia and Intensive Care Medicine. Swedish Society of Anaesthesia and Intensive Care Medicine. Available at: https://sfai.se/wp-content/uploads/2015/02/Riktlinjer-Svensk-Intensivvård_-rev-2015.pdf [Accessed 9 December 2020]. National Intensive Care Priorities in Sweden under extraordinary circumstances. Swedish National Board of Health and Welfare. Available at: https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/dokument-webb/ovrigt/nationella-prioriteringar-intensivvarden.pdf [Accessed 9 December 2020]. Så påverkar corona möjligheten att opereras. Sveriges Television. Available at: https://www.svt.se/datajournalistik/corona-uteblivna-operationer/ [Accessed 20 October 2020]. |
| سلسلة جزيئية: | ClinicalTrials.gov NCT04462393 |
| تواريخ الأحداث: | Date Created: 20210203 Date Completed: 20210316 Latest Revision: 20210506 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1097/EJA.0000000000001459 |
| PMID: | 33534266 |
| قاعدة البيانات: | MEDLINE |
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