tetano
Editor, Senior Moderator
J Anesth
. 2025 Jul 17.
doi: 10.1007/s00540-025-03549-z. Online ahead of print. Impact of the ICU admission of patients with COVID-19 on the outcomes of patients without COVID-19 in the ICU: a retrospective cohort study
Chikashi Takeda[SUP] 1 2 [/SUP], Masaaki Sakuraya[SUP] 3 [/SUP], Sachiko Tanaka-Mizuno[SUP] 4 5 [/SUP], Kotaro Sakurai[SUP] 6 4 [/SUP], Shinichi Kai[SUP] 6 [/SUP], Toshiyuki Mizota[SUP] 6 [/SUP], Moritoki Egi[SUP] 6 [/SUP]
Affiliations
Purpose: This study aimed to elucidate how the admission of patients with coronavirus disease-2019 (COVID-19) to the intensive care unit (ICU) impacts the mortality rate and management of patients without COVID-19 in the ICU, focusing on the condition of patients during and after ICU admission, which has not been sufficiently evaluated.
Methods: This multicenter retrospective cohort study was conducted across 33 ICU facilities in Japan, using data from the Japanese Intensive Care Patient Database for fiscal years 2018-2020. Patients without COVID-19 were admitted to ICUs that also treated patients with COVID-19 during the study period. Of the 68,620 patients without COVID-19, 11,503 were admitted during the COVID-19 period. The primary outcome was in-hospital mortality. The secondary outcomes included ICU mortality, off-hour ICU discharge, ICU discharge with mechanical ventilation, and incidence of tracheotomy.
Results: Adjusted analyses revealed no significant difference in in-hospital mortality (adjusted odds ratio [aOR] = 0.90; p = 0.071) but lower ICU mortality (aOR = 0.75; p = 0.001) during the COVID-19 period. The COVID-19 period was associated with increased off-hour ICU discharges (aOR = 1.37; p < 0.001), higher tracheotomy rates (aOR = 1.45; p = 0.018), and increased ICU discharges requiring mechanical ventilation (aOR = 1.21; p = 0.006). Moreover, ICU bed occupancy rates were lower in patients without COVID-19.
Conclusion: In-hospital mortality in patients without COVID-19 during the COVID-19 period was not significantly different from that during the non-COVID-19 period. While ICU mortality decreased, the tracheostomy rate, rate of patients requiring ventilators at the time of ICU discharge, and rate of transfer to other facilities increased.
Keywords: Bed occupancy; COVID-19 pandemic; Intensive care unit; Mortality; Patient discharge.
. 2025 Jul 17.
doi: 10.1007/s00540-025-03549-z. Online ahead of print. Impact of the ICU admission of patients with COVID-19 on the outcomes of patients without COVID-19 in the ICU: a retrospective cohort study
Chikashi Takeda[SUP] 1 2 [/SUP], Masaaki Sakuraya[SUP] 3 [/SUP], Sachiko Tanaka-Mizuno[SUP] 4 5 [/SUP], Kotaro Sakurai[SUP] 6 4 [/SUP], Shinichi Kai[SUP] 6 [/SUP], Toshiyuki Mizota[SUP] 6 [/SUP], Moritoki Egi[SUP] 6 [/SUP]
Affiliations
- PMID: 40676283
- DOI: 10.1007/s00540-025-03549-z
Purpose: This study aimed to elucidate how the admission of patients with coronavirus disease-2019 (COVID-19) to the intensive care unit (ICU) impacts the mortality rate and management of patients without COVID-19 in the ICU, focusing on the condition of patients during and after ICU admission, which has not been sufficiently evaluated.
Methods: This multicenter retrospective cohort study was conducted across 33 ICU facilities in Japan, using data from the Japanese Intensive Care Patient Database for fiscal years 2018-2020. Patients without COVID-19 were admitted to ICUs that also treated patients with COVID-19 during the study period. Of the 68,620 patients without COVID-19, 11,503 were admitted during the COVID-19 period. The primary outcome was in-hospital mortality. The secondary outcomes included ICU mortality, off-hour ICU discharge, ICU discharge with mechanical ventilation, and incidence of tracheotomy.
Results: Adjusted analyses revealed no significant difference in in-hospital mortality (adjusted odds ratio [aOR] = 0.90; p = 0.071) but lower ICU mortality (aOR = 0.75; p = 0.001) during the COVID-19 period. The COVID-19 period was associated with increased off-hour ICU discharges (aOR = 1.37; p < 0.001), higher tracheotomy rates (aOR = 1.45; p = 0.018), and increased ICU discharges requiring mechanical ventilation (aOR = 1.21; p = 0.006). Moreover, ICU bed occupancy rates were lower in patients without COVID-19.
Conclusion: In-hospital mortality in patients without COVID-19 during the COVID-19 period was not significantly different from that during the non-COVID-19 period. While ICU mortality decreased, the tracheostomy rate, rate of patients requiring ventilators at the time of ICU discharge, and rate of transfer to other facilities increased.
Keywords: Bed occupancy; COVID-19 pandemic; Intensive care unit; Mortality; Patient discharge.