tetano
Editor, Senior Moderator
Resuscitation
. 2023 Jun 28;109890.
doi: 10.1016/j.resuscitation.2023.109890. Online ahead of print. Outcomes after cardiac arrest in Medical Intensive Care Unit: A propensity score matching analysis of COVID-19 MICU vs non COVID-19 MICU cardiac arrest
Abhishek Bhardwaj[SUP] 1 [/SUP], Mahmoud Alwakeel[SUP] 2 [/SUP], Jason Kirincich[SUP] 3 [/SUP], Hassan Shaheen[SUP] 4 [/SUP], David F Gaieski[SUP] 5 [/SUP], Benjamin S Abella[SUP] 6 [/SUP], Xiaofeng Wang[SUP] 7 [/SUP], Mohammed J Al-Jaghbeer[SUP] 2 [/SUP], Abhijit Duggal[SUP] 2 [/SUP], Francois Abi Fadel[SUP] 2 [/SUP], Sudhir Krishnan[SUP] 8 [/SUP]
Affiliations
Aim: To assess whether there were differences in resuscitation efforts and outcomes for medical intensive care unit (MICU) in-hospital cardiac arrest (IHCA) during the COVID-19 pandemic when compared to pre-pandemic.
Methods: Comparing COVID-19 MICU-IHCA patients (03/2020 to 10/2020) to non-COVID-19 MICU IHCA (01/2014 to 12/2018) at Clevleand Clinic Health System (CCHS) of NE Ohio. Propensity score matching analysis (PSMA) was used to create comparable groups.
Results: There werea total of 516 patients, 51 in COVID-19 MICU IHCA cohort and 465 in the non-COVID-19 MICU IHCA cohort. The mean (SD) age of the study population was 60.9 (16) years and 56% were males. In 92.1% (n=475) patients, initial arrest rhythm was non-shockable. At the time of ICU admission, compared to the non-COVID-19 MICU-IHCA cohort, the COVID-19 MICU IHCA cohort had a lower mean APACHE III score (70 [32.9] vs 101.3 [39.6], P=<0.01). The COVID-19 cohort had a higher rate of survival to hospital discharge (12 [23.5%] vs 59 [12.7%], P=0.03). Upon PSMA, the algorithm selected 40 COVID-19 patients and 200 non-COVID-19 patients. Imbalances in baseline characteristics, comorbidities, and APACHE III were well-balanced after matching. Survival rate after matching became non-significant; (10 [25%) vs 42 [21%], P=0.67). Further, there were no significant differences in ICU or hospital length-of-stay or neurological outcomes at discharge for survivors in the two matched cohorts.
Conclusion: It is imperative that COVID-19 patients receive unbiased and unrestricted resuscitation measures, without any discouragement.
Keywords: Cardiac Arrest; Propensity score matching analysis; cardiopulmonary resuscitation; coronavirus disease 2019; resuscitation; severe acute respiratory syndrome coronavirus 2.
. 2023 Jun 28;109890.
doi: 10.1016/j.resuscitation.2023.109890. Online ahead of print. Outcomes after cardiac arrest in Medical Intensive Care Unit: A propensity score matching analysis of COVID-19 MICU vs non COVID-19 MICU cardiac arrest
Abhishek Bhardwaj[SUP] 1 [/SUP], Mahmoud Alwakeel[SUP] 2 [/SUP], Jason Kirincich[SUP] 3 [/SUP], Hassan Shaheen[SUP] 4 [/SUP], David F Gaieski[SUP] 5 [/SUP], Benjamin S Abella[SUP] 6 [/SUP], Xiaofeng Wang[SUP] 7 [/SUP], Mohammed J Al-Jaghbeer[SUP] 2 [/SUP], Abhijit Duggal[SUP] 2 [/SUP], Francois Abi Fadel[SUP] 2 [/SUP], Sudhir Krishnan[SUP] 8 [/SUP]
Affiliations
- PMID: 37390957
- DOI: 10.1016/j.resuscitation.2023.109890
Aim: To assess whether there were differences in resuscitation efforts and outcomes for medical intensive care unit (MICU) in-hospital cardiac arrest (IHCA) during the COVID-19 pandemic when compared to pre-pandemic.
Methods: Comparing COVID-19 MICU-IHCA patients (03/2020 to 10/2020) to non-COVID-19 MICU IHCA (01/2014 to 12/2018) at Clevleand Clinic Health System (CCHS) of NE Ohio. Propensity score matching analysis (PSMA) was used to create comparable groups.
Results: There werea total of 516 patients, 51 in COVID-19 MICU IHCA cohort and 465 in the non-COVID-19 MICU IHCA cohort. The mean (SD) age of the study population was 60.9 (16) years and 56% were males. In 92.1% (n=475) patients, initial arrest rhythm was non-shockable. At the time of ICU admission, compared to the non-COVID-19 MICU-IHCA cohort, the COVID-19 MICU IHCA cohort had a lower mean APACHE III score (70 [32.9] vs 101.3 [39.6], P=<0.01). The COVID-19 cohort had a higher rate of survival to hospital discharge (12 [23.5%] vs 59 [12.7%], P=0.03). Upon PSMA, the algorithm selected 40 COVID-19 patients and 200 non-COVID-19 patients. Imbalances in baseline characteristics, comorbidities, and APACHE III were well-balanced after matching. Survival rate after matching became non-significant; (10 [25%) vs 42 [21%], P=0.67). Further, there were no significant differences in ICU or hospital length-of-stay or neurological outcomes at discharge for survivors in the two matched cohorts.
Conclusion: It is imperative that COVID-19 patients receive unbiased and unrestricted resuscitation measures, without any discouragement.
Keywords: Cardiac Arrest; Propensity score matching analysis; cardiopulmonary resuscitation; coronavirus disease 2019; resuscitation; severe acute respiratory syndrome coronavirus 2.