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Association of Surge Conditions with Mortality Among Critically Ill Patients with COVID-19.
- Source :
-
Journal of intensive care medicine [J Intensive Care Med] 2022 Apr; Vol. 37 (4), pp. 500-509. Date of Electronic Publication: 2021 Dec 23. - Publication Year :
- 2022
-
Abstract
- Objective: To determine whether surge conditions were associated with increased mortality.<br />Design: Multicenter cohort study.<br />Setting: U.S. ICUs participating in STOP-COVID.<br />Patients: Consecutive adults with COVID-19 admitted to participating ICUs between March 4 and July 1, 2020.<br />Interventions: None.<br />Measurements and Main Results: 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], pā=ā.6). In analysis 2, surge was associated with an increased odds of death (odds ratio 1.39 [95% CI, 1.34-1.43], pā<ā.001).<br />Conclusions: 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.
Details
- Language :
- English
- ISSN :
- 1525-1489
- Volume :
- 37
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of intensive care medicine
- Publication Type :
- Academic Journal
- Accession number :
- 34939474
- Full Text :
- https://doi.org/10.1177/08850666211067509