National outcomes and characteristics of patients admitted to Swedish intensive care units for COVID-19 : A registry-based cohort study
Copyright © 2021 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited..
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.
| Errataetall: |
CommentIn: Eur J Anaesthesiol. 2021 Apr 1;38(4):331-332. - PMID 33661825 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
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| Enthalten in: |
European journal of anaesthesiology - 38(2021), 4 vom: 01. Apr., Seite 335-343 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Chew, Michelle S [VerfasserIn] |
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| Anmerkungen: |
Date Completed 16.03.2021 Date Revised 06.05.2021 published: Print ClinicalTrials.gov: NCT04462393 CommentIn: Eur J Anaesthesiol. 2021 Apr 1;38(4):331-332. - PMID 33661825 Citation Status MEDLINE |
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| doi: |
10.1097/EJA.0000000000001459 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM320950948 |
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| 100 | 1 | |a Chew, Michelle S |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a National outcomes and characteristics of patients admitted to Swedish intensive care units for COVID-19 |b A registry-based cohort study |
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| 500 | |a Date Completed 16.03.2021 | ||
| 500 | |a Date Revised 06.05.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a ClinicalTrials.gov: NCT04462393 | ||
| 500 | |a CommentIn: Eur J Anaesthesiol. 2021 Apr 1;38(4):331-332. - PMID 33661825 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited. | ||
| 520 | |a 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 | ||
| 520 | |a OBJECTIVE: To evaluate baseline characteristics, treatments and 30-day outcomes of patients admitted to Swedish ICUs with COVID-19 | ||
| 520 | |a DESIGN: Registry-based cohort study with prospective data collection | ||
| 520 | |a SETTING: Admissions to Swedish ICUs from 6 March to 6 May 2020 with laboratory confirmed COVID-19 disease | ||
| 520 | |a PARTICIPANTS: Adult patients admitted to Swedish ICUs | ||
| 520 | |a EXPOSURES: Baseline characteristics, intensive care treatments and organ failures | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a TRIAL REGISTRATION NO: NCT04462393 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 700 | 1 | |a Blixt, Patrik Johansson |e verfasserin |4 aut | |
| 700 | 1 | |a Åhman, Rasmus |e verfasserin |4 aut | |
| 700 | 1 | |a Engerström, Lars |e verfasserin |4 aut | |
| 700 | 1 | |a Andersson, Henrik |e verfasserin |4 aut | |
| 700 | 1 | |a Berggren, Ritva Kiiski |e verfasserin |4 aut | |
| 700 | 1 | |a Tegnell, Anders |e verfasserin |4 aut | |
| 700 | 1 | |a McIntyre, Sarah |e verfasserin |4 aut | |
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