Discharge Disposition and Loss of Independence Among Survivors of COVID-19 Admitted to Intensive Care: Results From the SCCM Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS).

Autor: Siddiqui S; Center for Anesthesia Research Excellence (CARE), Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA, USA., Kelly L; Center for Anesthesia Research Excellence (CARE), Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA, USA., Bosch N; Boston University School of Medicine, Boston, MA, USA., Law A; Boston University School of Medicine, Boston, MA, USA., Patel LA; Allina Health (Abbott Northwestern Hospital), Minneapolis, MN, USA., Perkins N; Greenville Memorial Hospital, Greenville, SC, USA., Armaignac DL; Baptist Health South Florida, Miami, FL, USA., Zabolotskikh I; Kuban State Medical University, Krasnodar, Russia., Christie A; Atrium Health Navicent the Medical Center, Macon, GA, USA., Krishna Mohan S; Panimalar Medical College Hospital & Research Institute, Chennai, India., Deo N; Mayo Clinic Rochester, Rochester, MN, USA., Bansal V; Mayo Clinic Rochester, Rochester, MN, USA., Kumar VK; Society of Critical Care Medicine, Mount Prospect, IL, USA., Gajic O; Mayo Clinic Rochester, Rochester, MN, USA., Kashyap R; Mayo Clinic Rochester, Rochester, MN, USA., Domecq JP; Mayo Clinic Rochester, Rochester, MN, USA., Boman K; Society of Critical Care Medicine, Mount Prospect, IL, USA., Walkey A; Boston University School of Medicine, Boston, MA, USA., Banner-Goodspeed V; Center for Anesthesia Research Excellence (CARE), Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA, USA., Schaefer MS; Center for Anesthesia Research Excellence (CARE), Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA, USA.; Department of Anesthesiology, Duesseldorf University Hospital, Duesseldorf, Germany.
Jazyk: angličtina
Zdroj: Journal of intensive care medicine [J Intensive Care Med] 2023 Oct; Vol. 38 (10), pp. 931-938. Date of Electronic Publication: 2023 May 08.
DOI: 10.1177/08850666231174375
Abstrakt: Objectives: To describe incidence and risk factors of loss of previous independent living through nonhome discharge or discharge home with health assistance in survivors of intensive care unit (ICU) admission for coronavirus disease 2019 (COVID-19).
Design: Multicenter observational study including patients admitted to the ICU from January 2020 till June 30, 2021.
Hypothesis: We hypothesized that there is a high risk of nonhome discharge in patients surviving ICU admission due to COVID-19.
Setting: Data were included from 306 hospitals in 28 countries participating in the SCCM Discovery Viral Infection and Respiratory Illness Universal Study COVID-19 registry.
Patients: Previously independently living adult ICU survivors of COVID-19.
Interventions: None.
Measurements and Main Results: The primary outcome was nonhome discharge. Secondary outcome was the requirement of health assistance among patients who were discharged home. Out of 10 820 patients, 7101 (66%) were discharged alive; 3791 (53%) of these survivors lost their previous independent living status, out of those 2071 (29%) through nonhome discharge, and 1720 (24%) through discharge home requiring health assistance. In adjusted analyses, loss of independence on discharge among survivors was predicted by patient age ≥ 65 years (adjusted odds ratio [aOR] 2.78, 95% confidence interval [CI] 2.47-3.14, P  < .0001), former and current smoking status (aOR 1.25, 95% CI 1.08-1.46, P   =  .003 and 1.60 (95% CI 1.18-2.16), P   =  .003, respectively), substance use disorder (aOR 1.52, 95% CI 1.12-2.06, P   =  .007), requirement for mechanical ventilation (aOR 4.17, 95% CI 3.69-4.71, P  < .0001), prone positioning (aOR 1.19, 95% CI 1.03-1.38, P   =  .02), and requirement for extracorporeal membrane oxygenation (aOR 2.28, 95% CI 1.55-3.34, P  < .0001).
Conclusions: More than half of ICU survivors hospitalized for COVID-19 are unable to return to independent living status, thereby imposing a significant secondary strain on health care systems worldwide.
Databáze: MEDLINE
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