tetano
Editor, Senior Moderator
Crit Care Resusc
. 2023 Oct 18;23(3):308-319.
doi: 10.51893/2021.3.OA8. eCollection 2021 Sep 6. Comparison of baseline characteristics, treatment and celinical outcomes of critically ill COVID-19 patients admitted in the first and second waves in Australia
Aidan J C Burrell[SUP] 1 2 [/SUP], Ary Serpa Neto[SUP] 1 [/SUP], Tessa Broadley[SUP] 1 [/SUP], Tony Trapani[SUP] 1 [/SUP], Husna Begum[SUP] 1 [/SUP], Lewis T Campbell[SUP] 3 4 [/SUP], Allen C Cheng[SUP] 5 6 [/SUP], Winston Cheung[SUP] 7 [/SUP], D James Cooper[SUP] 1 2 [/SUP], Simon J Erickson[SUP] 8 [/SUP], Craig J French[SUP] 1 9 [/SUP], John M Kaldor[SUP] 10 [/SUP], Edward Litton[SUP] 11 12 [/SUP], Srinivas Murthy[SUP] 13 [/SUP], Richard E McAllister[SUP] 14 [/SUP], Alistair D Nichol[SUP] 1 2 [/SUP], Annamaria Palermo[SUP] 11 [/SUP], Mark P Plummer[SUP] 15 [/SUP], Mahesh Ramanan[SUP] 16 [/SUP], Benjamin A J Reddi[SUP] 17 18 [/SUP], Claire Reynolds[SUP] 19 [/SUP], Steve A Webb[SUP] 1 12 [/SUP], Andrew A Udy[SUP] 1 2 [/SUP]; SPRINT SARI Australia Investigators
Affiliations
Objective: To report longitudinal differences in baseline characteristics, treatment, and outcomes in patients with coronavirus disease 2019 (COVID-19) admitted to intensive care units (ICUs) between the first and second waves of COVID-19 in Australia. Design, setting and participants: SPRINT-SARI Australia is a multicentre, inception cohort study enrolling adult patients with COVID-19 admitted to participating ICUs. The first wave of COVID-19 was from 27 February to 30 June 2020, and the second wave was from 1 July to 22 October 2020. Results: A total of 461 patients were recruited in 53 ICUs across Australia; a higher number were admitted to the ICU during the second wave compared with the first: 255 (55.3%) versus 206 (44.7%). Patients admitted to the ICU in the second wave were younger (58.0 v 64.0 years; P = 0.001) and less commonly male (68.9% v 60.0%; P = 0.045), although Acute Physiology and Chronic Health Evaluation (APACHE) II scores were similar (14 v 14; P = 0.998). High flow oxygen use (75.2% v 43.4%; P < 0.001) and non-invasive ventilation (16.5% v 7.1%; P = 0.002) were more common in the second wave, as was steroid use (95.0% v 30.3%; P < 0.001). ICU length of stay was shorter (6.0 v 8.4 days; P = 0.003). In-hospital mortality was similar (12.2% v 14.6%; P = 0.452), but observed mortality decreased over time and patients were more likely to be discharged alive earlier in their ICU admission (hazard ratio, 1.43; 95% CI, 1.13-1.79; P = 0.002). Conclusion: During the second wave of COVID-19 in Australia, ICU length of stay and observed mortality decreased over time. Multiple factors were associated with this, including changes in clinical management, the adoption of new evidence-based treatments, and changes in patient demographic characteristics but not illness severity.
. 2023 Oct 18;23(3):308-319.
doi: 10.51893/2021.3.OA8. eCollection 2021 Sep 6. Comparison of baseline characteristics, treatment and celinical outcomes of critically ill COVID-19 patients admitted in the first and second waves in Australia
Aidan J C Burrell[SUP] 1 2 [/SUP], Ary Serpa Neto[SUP] 1 [/SUP], Tessa Broadley[SUP] 1 [/SUP], Tony Trapani[SUP] 1 [/SUP], Husna Begum[SUP] 1 [/SUP], Lewis T Campbell[SUP] 3 4 [/SUP], Allen C Cheng[SUP] 5 6 [/SUP], Winston Cheung[SUP] 7 [/SUP], D James Cooper[SUP] 1 2 [/SUP], Simon J Erickson[SUP] 8 [/SUP], Craig J French[SUP] 1 9 [/SUP], John M Kaldor[SUP] 10 [/SUP], Edward Litton[SUP] 11 12 [/SUP], Srinivas Murthy[SUP] 13 [/SUP], Richard E McAllister[SUP] 14 [/SUP], Alistair D Nichol[SUP] 1 2 [/SUP], Annamaria Palermo[SUP] 11 [/SUP], Mark P Plummer[SUP] 15 [/SUP], Mahesh Ramanan[SUP] 16 [/SUP], Benjamin A J Reddi[SUP] 17 18 [/SUP], Claire Reynolds[SUP] 19 [/SUP], Steve A Webb[SUP] 1 12 [/SUP], Andrew A Udy[SUP] 1 2 [/SUP]; SPRINT SARI Australia Investigators
Affiliations
- PMID: 38046076
- PMCID: PMC10692524
- DOI: 10.51893/2021.3.OA8
Objective: To report longitudinal differences in baseline characteristics, treatment, and outcomes in patients with coronavirus disease 2019 (COVID-19) admitted to intensive care units (ICUs) between the first and second waves of COVID-19 in Australia. Design, setting and participants: SPRINT-SARI Australia is a multicentre, inception cohort study enrolling adult patients with COVID-19 admitted to participating ICUs. The first wave of COVID-19 was from 27 February to 30 June 2020, and the second wave was from 1 July to 22 October 2020. Results: A total of 461 patients were recruited in 53 ICUs across Australia; a higher number were admitted to the ICU during the second wave compared with the first: 255 (55.3%) versus 206 (44.7%). Patients admitted to the ICU in the second wave were younger (58.0 v 64.0 years; P = 0.001) and less commonly male (68.9% v 60.0%; P = 0.045), although Acute Physiology and Chronic Health Evaluation (APACHE) II scores were similar (14 v 14; P = 0.998). High flow oxygen use (75.2% v 43.4%; P < 0.001) and non-invasive ventilation (16.5% v 7.1%; P = 0.002) were more common in the second wave, as was steroid use (95.0% v 30.3%; P < 0.001). ICU length of stay was shorter (6.0 v 8.4 days; P = 0.003). In-hospital mortality was similar (12.2% v 14.6%; P = 0.452), but observed mortality decreased over time and patients were more likely to be discharged alive earlier in their ICU admission (hazard ratio, 1.43; 95% CI, 1.13-1.79; P = 0.002). Conclusion: During the second wave of COVID-19 in Australia, ICU length of stay and observed mortality decreased over time. Multiple factors were associated with this, including changes in clinical management, the adoption of new evidence-based treatments, and changes in patient demographic characteristics but not illness severity.