tetano
Editor, Senior Moderator
Ann Am Thorac Soc
. 2022 Feb 25.
doi: 10.1513/AnnalsATS.202106-705OC. Online ahead of print.
Mortality of Mechanically Ventilated COVID-19 Patients in Traditional versus Expanded ICUs in NY
Mitsuaki Nishikimi[SUP] 1 2 [/SUP], Daniel Jafari[SUP] 3 2 [/SUP], Neha Singh[SUP] 4 [/SUP], Koichiro Shinozaki[SUP] 1 2 [/SUP], Cristina P Sison[SUP] 5 [/SUP], Muhammad Shoaib[SUP] 1 6 [/SUP], Jonathan Gong[SUP] 2 [/SUP], Rehana Rasul[SUP] 7 [/SUP], Timmy Li[SUP] 6 2 [/SUP], Kei Hayashida[SUP] 1 [/SUP], Daniel M Rolston[SUP] 6 3 2 [/SUP], Santiago J Miyara[SUP] 1 [/SUP], Jamie S Hirsch[SUP] 8 6 [/SUP], Amir Gandomi[SUP] 9 [/SUP], Maureen T White[SUP] 10 [/SUP], Mark P Jarrett[SUP] 11 6 [/SUP], Martin L Lesser[SUP] 5 [/SUP], Lance B Becker[SUP] 1 2 12 [/SUP], Northwell Health COVID-19 Research Consortium
Affiliations
Abstract
Rationale: During the first wave of the coronavirus disease 2019 (COVID-19) pandemic in New York City, the number of mechanically ventilated COVID-19 patients rapidly surpassed the capacity of traditional Intensive Care Units (ICUs), resulting in health systems utilizing other areas as expanded ICUs to provide critical care.
Objectives: To evaluate the mortality of patients admitted to expanded ICUs compared with those admitted to traditional ICUs.
Methods: Multicenter, retrospective, cohort study of mechanically ventilated patients with COVID-19 admitted to the ICUs at 11 Northwell Health hospitals in the greater New York City area between March 1, 2020 and April 30, 2020.
Measurements: In-hospital mortality up to 28 days after intubation of COVID-19 patients.
Results: Among 1,966 mechanically ventilated patients with COVID-19, 1,198 (61%) died within 28 days after intubation, 46 (2%) were transferred to other hospitals outside of the Northwell Health system, 722 (37%) survived in the hospital until 28 days or were discharged after recovery. The risk of mortality of mechanically ventilated patients admitted to expanded ICUs was not different from those admitted to traditional ICUs (HR, 1.07; 95% CI, 0.95-1.20; p = 0.28), while hospital occupancy for critically ill patients itself was associated with increased risk of mortality (HR, 1.28; 95% CI, 1.12-1.45; p < 0.001).
Conclusions: Although increased hospital occupancy for critically ill patients itself was associated with increased mortality, the risk of 28-day in-hospital mortality of mechanically ventilated patients with COVID-19 who were admitted to expanded ICUs was not different from those admitted to traditional ICUs.
. 2022 Feb 25.
doi: 10.1513/AnnalsATS.202106-705OC. Online ahead of print.
Mortality of Mechanically Ventilated COVID-19 Patients in Traditional versus Expanded ICUs in NY
Mitsuaki Nishikimi[SUP] 1 2 [/SUP], Daniel Jafari[SUP] 3 2 [/SUP], Neha Singh[SUP] 4 [/SUP], Koichiro Shinozaki[SUP] 1 2 [/SUP], Cristina P Sison[SUP] 5 [/SUP], Muhammad Shoaib[SUP] 1 6 [/SUP], Jonathan Gong[SUP] 2 [/SUP], Rehana Rasul[SUP] 7 [/SUP], Timmy Li[SUP] 6 2 [/SUP], Kei Hayashida[SUP] 1 [/SUP], Daniel M Rolston[SUP] 6 3 2 [/SUP], Santiago J Miyara[SUP] 1 [/SUP], Jamie S Hirsch[SUP] 8 6 [/SUP], Amir Gandomi[SUP] 9 [/SUP], Maureen T White[SUP] 10 [/SUP], Mark P Jarrett[SUP] 11 6 [/SUP], Martin L Lesser[SUP] 5 [/SUP], Lance B Becker[SUP] 1 2 12 [/SUP], Northwell Health COVID-19 Research Consortium
Affiliations
- PMID: 35213292
- DOI: 10.1513/AnnalsATS.202106-705OC
Abstract
Rationale: During the first wave of the coronavirus disease 2019 (COVID-19) pandemic in New York City, the number of mechanically ventilated COVID-19 patients rapidly surpassed the capacity of traditional Intensive Care Units (ICUs), resulting in health systems utilizing other areas as expanded ICUs to provide critical care.
Objectives: To evaluate the mortality of patients admitted to expanded ICUs compared with those admitted to traditional ICUs.
Methods: Multicenter, retrospective, cohort study of mechanically ventilated patients with COVID-19 admitted to the ICUs at 11 Northwell Health hospitals in the greater New York City area between March 1, 2020 and April 30, 2020.
Measurements: In-hospital mortality up to 28 days after intubation of COVID-19 patients.
Results: Among 1,966 mechanically ventilated patients with COVID-19, 1,198 (61%) died within 28 days after intubation, 46 (2%) were transferred to other hospitals outside of the Northwell Health system, 722 (37%) survived in the hospital until 28 days or were discharged after recovery. The risk of mortality of mechanically ventilated patients admitted to expanded ICUs was not different from those admitted to traditional ICUs (HR, 1.07; 95% CI, 0.95-1.20; p = 0.28), while hospital occupancy for critically ill patients itself was associated with increased risk of mortality (HR, 1.28; 95% CI, 1.12-1.45; p < 0.001).
Conclusions: Although increased hospital occupancy for critically ill patients itself was associated with increased mortality, the risk of 28-day in-hospital mortality of mechanically ventilated patients with COVID-19 who were admitted to expanded ICUs was not different from those admitted to traditional ICUs.