Intensive care unit staff preparedness as an independent factor for death of patients during COVID-19 pandemic: An observational cohort study
| Autor: | Renata Elisie Barbalho de Siqueira, Paula Carolinne Werlang Custodio, José E. Vidal, Claudia Figueiredo-Mello, Nidyanara Francine de Souza Castanheira, Caroline Martins Rego, Marina Pozzi Lanza, Ana Freitas Ribeiro, Ceila MariaAna SantMálaque, Jaques Sztajnbok, Roberta Figueiredo Cavalin |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty medicine.medical_treatment Population Infectious and parasitic diseases RC109-216 Single Center Microbiology law.invention Cohort Studies law Intensive care Medicine Humans Hospital Mortality education Pandemics Mechanical ventilation education.field_of_study Emergency preparedness Intensive care units business.industry SARS-CoV-2 COVID-19 Middle Aged Intensive care unit Respiration Artificial QR1-502 Infectious Diseases Preparedness Emergency medicine Observational study Original Article Severe acute respiratory disease business Brazil Cohort study |
| Zdroj: | The Brazilian Journal of Infectious Diseases Brazilian Journal of Infectious Diseases, Vol 25, Iss 6, Pp 101653-(2021) |
| ISSN: | 1678-4391 1413-8670 |
| Popis: | The pandemic of COVID-19 brought to the world an unprecedented challenge. This single center observational study aimed to evaluate the impact of staff preparedness by comparing the outcomes between two intensive care units (ICUs) from a hospital that had to expand ICU beds to deal with an incremented volume of critical patients. Patients consecutively admitted to these ICUs with suspected COVID-19, from March 1st until April 30th, 2020, were included. Both ICUs attended a similar population and had the same facilities, what differed was the staff: one previously well-established (ICU-1) and another recently assembled (ICU-2). 114 patients with severe respiratory syndrome were included. In-hospital mortality was 40%. Compared with patients in the well-established ICU-1, patients in the recently assembled ICU-2 were older (54 versus 61.5, p=0.045), received more antibiotics (93% versus 98%, p=0.001) and chloroquine/hydroxychloroquine 6% versus 30%, p=0.001), had a higher proportion of invasive mechanical ventilation (44% versus 52%, p=0.008) and had greater in-hospital mortality (30% versus 50%, p=0.017). The proportion of patients considered at high risk for death according to PSI was similar between the two ICU populations. Age ≥ 60 years (adjusted OR 2.33; 95% CI 1.02-5.31), need of invasive mechanical ventilation (adjusted OR 2.79; 95% CI 1.22-6.37), and ICU type (recently assembled) (adjusted OR 2.38; 95% CI 1.04-5.44) were independently associated with in-hospital mortality . This finding highlights the importance of developing support strategies to improve preparedness of staff recently assembled to deal with emergencies. |
| Databáze: | OpenAIRE |
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