Characteristics, interventions, and longer term outcomes of COVID-19 ICU patients in Denmark-A nationwide, observational study.

Autor: Haase N; Department of Intensive Care, Rigshospitalet, Copenhagen, Denmark., Plovsing R; Department of Anesthesiology and Intensive Care, Hvidovre Hospital, Copenhagen, Denmark., Christensen S; Department of Anesthesiology and Intensive Care, Århus University Hospital, Århus, Denmark., Poulsen LM; Department of Anesthesiology and Intensive Care, Zealand University Hospital, Køge, Denmark., Brøchner AC; Department of Anesthesiology and Intensive Care, Kolding Hospital, Kolding, Denmark., Rasmussen BS; Department of Anesthesiology and Intensive Care, Ålborg University Hospital, Ålborg, Denmark., Helleberg M; Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark., Jensen JUS; Department of Respiratory Medicine, Herlev-Gentofte Hospital, Copenhagen, Denmark., Andersen LPK; Department of Anesthesiology and Intensive Care, Bispebjerg Hospital, Copenhagen, Denmark., Siegel H; Department of Anesthesiology and Intensive Care, Herlev-Gentofte Hospital, Copenhagen, Denmark., Ibsen M; Department of Anesthesiology and Intensive Care, North Zealand Hospital, Hillerød, Denmark., Jørgensen V; Department of Cardiothoracic Anesthesiology, Rigshospitalet, Copenhagen, Denmark., Winding R; Department of Anesthesiology and Intensive Care, Herning Hospital, Herning, Denmark., Iversen S; Department of Anesthesiology and Intensive Care, Slagelse Hospital, Slagelse, Denmark., Pedersen HP; Department of Anesthesiology and Intensive Care, Zealand University Hospital, Roskilde, Denmark., Madsen J; Department of Anesthesiology and Intensive Care, Ålborg University Hospital, Ålborg, Denmark., Sølling C; Department of Anesthesiology and Intensive Care, Viborg Hospital, Viborg, Denmark., Garcia RS; Department of Anesthesiology and Intensive Care, Esbjerg Hospital, Esbjerg, Denmark., Michelsen J; Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark., Mohr T; Department of Anesthesiology and Intensive Care, Herlev-Gentofte Hospital, Copenhagen, Denmark., Mannering A; Department of Anesthesiology and Intensive Care, Svendborg Hospital, Svendborg, Denmark., Espelund US; Department of Anesthesiology and Intensive Care, Horsens Hospital, Horsens, Denmark., Bundgaard H; Department of Anesthesiology and Intensive Care, Randers Hospital, Randers, Denmark., Kirkegaard L; Department of Anesthesiology and Intensive Care, Åbenrå Hospital, Åbenrå, Denmark., Smitt M; Department of Neuroanesthesiology, Rigshospitalet, Copenhagen, Denmark., Buck DL; Department of Anesthesiology and Intensive Care, Holbaek Hospital, Holbaek, Denmark., Ribergaard NE; Department of Anesthesiology and Intensive Care, Hjørring Hospital, Hjørring, Denmark., Pedersen HS; Department of Anesthesiology and Intensive Care, Nykøbing Falster Hospital, Nykøbing Falster, Denmark., Christensen BV; Department of Anesthesiology and Intensive Care, Glostrup Hospital, Copenhagen, Denmark., Perner A; Department of Intensive Care, Rigshospitalet, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Acta anaesthesiologica Scandinavica [Acta Anaesthesiol Scand] 2021 Jan; Vol. 65 (1), pp. 68-75. Date of Electronic Publication: 2020 Oct 03.
DOI: 10.1111/aas.13701
Abstrakt: Background: Most data on intensive care unit (ICU) patients with COVID-19 originate in selected populations from stressed healthcare systems with shorter term follow-up. We present characteristics, interventions and longer term outcomes of the entire, unselected cohort of all ICU patients with COVID-19 in Denmark where the ICU capacity was not exceeded.
Methods: We identified all patients with SARS-CoV-2 admitted to any Danish ICU from 10 March to 19 May 2020 and registered demographics, chronic comorbidities, use of organ support, length of stay, and vital status from patient files. Risk factors for death were analyzed using adjusted Cox regression analysis.
Results: There were 323 ICU patients with confirmed COVID-19. Median age was 68 years, 74% were men, 50% had hypertension, 21% diabetes, and 20% chronic pulmonary disease; 29% had no chronic comorbidity. Invasive mechanical ventilation was used in 82%, vasopressors in 83%, renal replacement therapy in 26%, and extra corporeal membrane oxygenation in 8%. ICU stay was median 13 days (IQR 6-22) and hospital stay 19 days (11-30). Median follow-up was 79 days. At end of follow-up, 118 had died (37%), 15 (4%) were still in hospital hereof 4 in ICU as of 16 June 2020. Risk factors for mortality included male gender, age, chronic pulmonary disease, active cancer, and number of co-morbidities.
Conclusions: In this nationwide, population-based cohort of ICU patients with COVID-19, longer term survival was high despite high age and substantial use of organ support. Male gender, age, and chronic co-morbidities, in particular chronic pulmonary disease, were associated with increased risk of death.
(© 2020 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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