Differences and Similarities Among COVID-19 Patients Treated in Seven ICUs in Three Countries Within One Region: An Observational Cohort Study
| Autor: | Dieter, Mesotten, Daniek A M, Meijs, Bas C T, van Bussel, Björn, Stessel, Jannet, Mehagnoul-Schipper, Anisa, Hana, Clarissa I E, Scheeren, Ulrich, Strauch, Marcel C G, van de Poll, Chahinda, Ghossein-Doha, Wolfgang F F A, Buhre, Johannes, Bickenbach, Margot, Vander Laenen, Gernot, Marx, Iwan C C, van der Horst, Laura, Bormans-Russell |
|---|---|
| Přispěvatelé: | MUMC+: MA Medische Staf IC (9), RS: CAPHRI - R5 - Optimising Patient Care, Intensive Care, MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health, Cardiologie, MUMC+: MA Med Staf Artsass Cardiologie (9), RS: GROW - R4 - Reproductive and Perinatal Medicine, MUMC+: Centrum voor Acute en Kritieke Zorg (3), MUMC+: MA Anesthesiologie (3), RS: MHeNs - R3 - Neuroscience, MUMC+: MA Intensive Care (3), RS: Carim - V04 Surgical intervention |
| Rok vydání: | 2021 |
| Předmět: |
Male
Patient Transfer medicine.medical_specialty SEX-DIFFERENCES Coronavirus disease 2019 (COVID-19) Critical Care Psychological intervention Critical Care and Intensive Care Medicine Logistic regression CASE-FATALITY Cohort Studies coronavirus disease 2019 Internal medicine Health care Pandemic medicine Humans Socioeconomic status APACHE Aged OUTCOMES Descriptive statistics business.industry Patient Acuity COVID-19 Middle Aged Europe Intensive Care Units Logistic Models Treatment Outcome delivery of healthcare Female business COVID Data Platform (CoDaP) Investigators Cohort study healthcare economics and organizations severe acute respiratory syndrome coronavirus 2 |
| Zdroj: | Critical Care Medicine, 50(4), 595-606. LIPPINCOTT WILLIAMS & WILKINS |
| ISSN: | 1530-0293 0090-3493 |
| Popis: | OBJECTIVES: To investigate healthcare system-driven variation in general characteristics, interventions, and outcomes in coronavirus disease 2019 (COVID-19) patients admitted to the ICU within one Western European region across three countries. DESIGN: Multicenter observational cohort study. SETTING: Seven ICUs in the Euregio Meuse-Rhine, one region across Belgium, The Netherlands, and Germany. PATIENTS: Consecutive COVID-19 patients supported in the ICU during the first pandemic wave. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Baseline demographic and clinical characteristics, laboratory values, and outcome data were retrieved after ethical approval and data-sharing agreements. Descriptive statistics were performed to investigate country-related practice variation. From March 2, 2020, to August 12, 2020, 551 patients were admitted. Mean age was 65.4 ± 11.2 years, and 29% were female. At admission, Acute Physiology and Chronic Health Evaluation II scores were 15.0 ± 5.5, 16.8 ± 5.5, and 15.8 ± 5.3 (p = 0.002), and Sequential Organ Failure Assessment scores were 4.4 ± 2.7, 7.4 ± 2.2, and 7.7 ± 3.2 (p < 0.001) in the Belgian, Dutch, and German parts of Euregio, respectively. The ICU mortality rate was 22%, 42%, and 44%, respectively (p < 0.001). Large differences were observed in the frequency of organ support, antimicrobial/inflammatory therapy application, and ICU capacity. Mixed-multivariable logistic regression analyses showed that differences in ICU mortality were independent of age, sex, disease severity, comorbidities, support strategies, therapies, and complications. CONCLUSIONS: COVID-19 patients admitted to ICUs within one region, the Euregio Meuse-Rhine, differed significantly in general characteristics, applied interventions, and outcomes despite presumed genetic and socioeconomic background, admission diagnosis, access to international literature, and data collection are similar. Variances in healthcare systems' organization, particularly ICU capacity and admission criteria, combined with a rapidly spreading pandemic might be important drivers for the observed differences. Heterogeneity between patient groups but also healthcare systems should be presumed to interfere with outcomes in coronavirus disease 2019. ispartof: CRITICAL CARE MEDICINE vol:50 issue:4 pages:595-606 ispartof: location:United States status: published |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|