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ICU strain and outcome in COVID-19 patients—A multicenter retrospective observational study
PURPOSE: To compare the characteristics, management, and prognosis of patients admitted to intensive care units (ICU) for coronavirus disease (COVID)-19 during the first two waves of the outbreak and to evaluate the relationship between ICU strain (ICU demand due to COVID-19 admissions) and mortalit...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9295940/ https://www.ncbi.nlm.nih.gov/pubmed/35853020 http://dx.doi.org/10.1371/journal.pone.0271358 |
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author | Demoule, Alexandre Fartoukh, Muriel Louis, Guillaume Azoulay, Elie Nemlaghi, Safaa Jullien, Edouard Desnos, Cyrielle Clerc, Sebastien Yvin, Elise Mellati, Nouchan Charron, Cyril Voiriot, Guillaume Picard, Yoann Vieillard-Baron, Antoine Darmon, Michael |
author_facet | Demoule, Alexandre Fartoukh, Muriel Louis, Guillaume Azoulay, Elie Nemlaghi, Safaa Jullien, Edouard Desnos, Cyrielle Clerc, Sebastien Yvin, Elise Mellati, Nouchan Charron, Cyril Voiriot, Guillaume Picard, Yoann Vieillard-Baron, Antoine Darmon, Michael |
author_sort | Demoule, Alexandre |
collection | PubMed |
description | PURPOSE: To compare the characteristics, management, and prognosis of patients admitted to intensive care units (ICU) for coronavirus disease (COVID)-19 during the first two waves of the outbreak and to evaluate the relationship between ICU strain (ICU demand due to COVID-19 admissions) and mortality. METHODS: In a multicentre retrospective study, 1166 COVID-19 patients admitted to five ICUs in France between 20 February and 31 December 2020 were included. Data were collected at each ICU from medical records. A Cox proportional-hazards model identified factors associated with 28-day mortality. RESULTS: 640 patients (55%) were admitted during the first wave (February to June 2020) and 526 (45%) during the second wave (July to December 2020). ICU strain was lower during the second wave (-0.81 [-1.04 –-0.31] vs. 1.18 [-0.34–1.29] SD when compared to mean COVID-19 admission in each center during study period, P<0.001). Patients admitted during the second wave were older, had more profound hypoxemia and lower SOFA. High flow nasal cannula was more frequently used during the second wave (68% vs. 39%, P<0.001) and intubation was less frequent (46% vs. 69%, P<0.001). Neither 28-day mortality (30% vs. 26%, P = 0.12) nor hospital mortality (37% vs. 31%, P = 0.27) differed between first and second wave. Overweight and obesity were associated with lower 28-day mortality while older age, underlying chronic kidney disease, severity at ICU admission as assessed by SOFA score and ICU strain were associated with higher 28-day mortality. ICU strain was not associated with hospital mortality. CONCLUSION: The characteristics and the management of patients varied between the first and the second wave of the pandemic. Rather than the wave, ICU strain was independently associated with 28-day mortality, but not with hospital mortality. |
format | Online Article Text |
id | pubmed-9295940 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-92959402022-07-20 ICU strain and outcome in COVID-19 patients—A multicenter retrospective observational study Demoule, Alexandre Fartoukh, Muriel Louis, Guillaume Azoulay, Elie Nemlaghi, Safaa Jullien, Edouard Desnos, Cyrielle Clerc, Sebastien Yvin, Elise Mellati, Nouchan Charron, Cyril Voiriot, Guillaume Picard, Yoann Vieillard-Baron, Antoine Darmon, Michael PLoS One Research Article PURPOSE: To compare the characteristics, management, and prognosis of patients admitted to intensive care units (ICU) for coronavirus disease (COVID)-19 during the first two waves of the outbreak and to evaluate the relationship between ICU strain (ICU demand due to COVID-19 admissions) and mortality. METHODS: In a multicentre retrospective study, 1166 COVID-19 patients admitted to five ICUs in France between 20 February and 31 December 2020 were included. Data were collected at each ICU from medical records. A Cox proportional-hazards model identified factors associated with 28-day mortality. RESULTS: 640 patients (55%) were admitted during the first wave (February to June 2020) and 526 (45%) during the second wave (July to December 2020). ICU strain was lower during the second wave (-0.81 [-1.04 –-0.31] vs. 1.18 [-0.34–1.29] SD when compared to mean COVID-19 admission in each center during study period, P<0.001). Patients admitted during the second wave were older, had more profound hypoxemia and lower SOFA. High flow nasal cannula was more frequently used during the second wave (68% vs. 39%, P<0.001) and intubation was less frequent (46% vs. 69%, P<0.001). Neither 28-day mortality (30% vs. 26%, P = 0.12) nor hospital mortality (37% vs. 31%, P = 0.27) differed between first and second wave. Overweight and obesity were associated with lower 28-day mortality while older age, underlying chronic kidney disease, severity at ICU admission as assessed by SOFA score and ICU strain were associated with higher 28-day mortality. ICU strain was not associated with hospital mortality. CONCLUSION: The characteristics and the management of patients varied between the first and the second wave of the pandemic. Rather than the wave, ICU strain was independently associated with 28-day mortality, but not with hospital mortality. Public Library of Science 2022-07-19 /pmc/articles/PMC9295940/ /pubmed/35853020 http://dx.doi.org/10.1371/journal.pone.0271358 Text en © 2022 Demoule et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Demoule, Alexandre Fartoukh, Muriel Louis, Guillaume Azoulay, Elie Nemlaghi, Safaa Jullien, Edouard Desnos, Cyrielle Clerc, Sebastien Yvin, Elise Mellati, Nouchan Charron, Cyril Voiriot, Guillaume Picard, Yoann Vieillard-Baron, Antoine Darmon, Michael ICU strain and outcome in COVID-19 patients—A multicenter retrospective observational study |
title | ICU strain and outcome in COVID-19 patients—A multicenter retrospective observational study |
title_full | ICU strain and outcome in COVID-19 patients—A multicenter retrospective observational study |
title_fullStr | ICU strain and outcome in COVID-19 patients—A multicenter retrospective observational study |
title_full_unstemmed | ICU strain and outcome in COVID-19 patients—A multicenter retrospective observational study |
title_short | ICU strain and outcome in COVID-19 patients—A multicenter retrospective observational study |
title_sort | icu strain and outcome in covid-19 patients—a multicenter retrospective observational study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9295940/ https://www.ncbi.nlm.nih.gov/pubmed/35853020 http://dx.doi.org/10.1371/journal.pone.0271358 |
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