Association of Surge Conditions with Mortality Among Critically Ill Patients with COVID-19.
J Intensive Care Med
; 37(4): 500-509, 2022 04.
Article
in English
| MEDLINE | ID: covidwho-1582678
ABSTRACT
OBJECTIVE:
To determine whether surge conditions were associated with increased mortality.DESIGN:
Multicenter cohort study.SETTING:
U.S. ICUs participating in STOP-COVID. PATIENTS Consecutive adults with COVID-19 admitted to participating ICUs between March 4 and July 1, 2020.INTERVENTIONS:
None. MEASUREMENTS AND MAINRESULTS:
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 < .001).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.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Critical Illness
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
/
Reviews
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
J Intensive Care Med
Journal subject:
Critical Care
Year:
2022
Document Type:
Article
Affiliation country:
08850666211067509
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