Characteristics and outcome of COVID-19 patients admitted to the ICU: a nationwide cohort study on the comparison between the first and the consecutive upsurges of the second wave of the COVID-19 pandemic in the Netherlands.
COVID-19
Coronavirus
Critical Care
Intensive Care
Mortality
Outcome
Journal
Annals of intensive care
ISSN: 2110-5820
Titre abrégé: Ann Intensive Care
Pays: Germany
ID NLM: 101562873
Informations de publication
Date de publication:
13 Jan 2022
13 Jan 2022
Historique:
received:
27
07
2021
accepted:
26
12
2021
entrez:
13
1
2022
pubmed:
14
1
2022
medline:
14
1
2022
Statut:
epublish
Résumé
To assess trends in the quality of care for COVID-19 patients at the ICU over the course of time in the Netherlands. Data from the National Intensive Care Evaluation (NICE)-registry of all COVID-19 patients admitted to an ICU in the Netherlands were used. Patient characteristics and indicators of quality of care during the first two upsurges (N = 4215: October 5, 2020-January 31, 2021) and the final upsurge of the second wave, called the 'third wave' (N = 4602: February 1, 2021-June 30, 2021) were compared with those during the first wave (N = 2733, February-May 24, 2020). During the second and third wave, there were less patients treated with mechanical ventilation (58.1 and 58.2%) and vasoactive drugs (48.0 and 44.7%) compared to the first wave (79.1% and 67.2%, respectively). The occupancy rates as fraction of occupancy in 2019 (1.68 and 1.55 vs. 1.83), the numbers of ICU relocations (23.8 and 27.6 vs. 32.3%) and the mean length of stay at the ICU (HRs of ICU discharge = 1.26 and 1.42) were lower during the second and third wave. No difference in adjusted hospital mortality between the second wave and the first wave was found, whereas the mortality during the third wave was considerably lower (OR = 0.80, 95% CI [0.71-0.90]). These data show favorable shifts in the treatment of COVID-19 patients at the ICU over time. The adjusted mortality decreased in the third wave. The high ICU occupancy rate early in the pandemic does probably not explain the high mortality associated with COVID-19.
Sections du résumé
BACKGROUND
BACKGROUND
To assess trends in the quality of care for COVID-19 patients at the ICU over the course of time in the Netherlands.
METHODS
METHODS
Data from the National Intensive Care Evaluation (NICE)-registry of all COVID-19 patients admitted to an ICU in the Netherlands were used. Patient characteristics and indicators of quality of care during the first two upsurges (N = 4215: October 5, 2020-January 31, 2021) and the final upsurge of the second wave, called the 'third wave' (N = 4602: February 1, 2021-June 30, 2021) were compared with those during the first wave (N = 2733, February-May 24, 2020).
RESULTS
RESULTS
During the second and third wave, there were less patients treated with mechanical ventilation (58.1 and 58.2%) and vasoactive drugs (48.0 and 44.7%) compared to the first wave (79.1% and 67.2%, respectively). The occupancy rates as fraction of occupancy in 2019 (1.68 and 1.55 vs. 1.83), the numbers of ICU relocations (23.8 and 27.6 vs. 32.3%) and the mean length of stay at the ICU (HRs of ICU discharge = 1.26 and 1.42) were lower during the second and third wave. No difference in adjusted hospital mortality between the second wave and the first wave was found, whereas the mortality during the third wave was considerably lower (OR = 0.80, 95% CI [0.71-0.90]).
CONCLUSIONS
CONCLUSIONS
These data show favorable shifts in the treatment of COVID-19 patients at the ICU over time. The adjusted mortality decreased in the third wave. The high ICU occupancy rate early in the pandemic does probably not explain the high mortality associated with COVID-19.
Identifiants
pubmed: 35024981
doi: 10.1186/s13613-021-00978-3
pii: 10.1186/s13613-021-00978-3
pmc: PMC8755895
doi:
Types de publication
Journal Article
Langues
eng
Pagination
5Subventions
Organisme : ZonMw
ID : 10430 01 201 0011: IRIS
Pays : Netherlands
Investigateurs
Dirk P Verbiest
(DP)
Leo F Te Velde
(LF)
Erik M van Driel
(EM)
Tom Rijpstra
(T)
Paul W G Elbers
(PWG)
Lyuba Georgieva
(L)
Eva Verweij
(E)
Remko M de Jong
(RM)
Freya M van Iersel
(FM)
Dick T J J Koning
(DTJJ)
Els Rengers
(E)
Nuray Kusadasi
(N)
Michiel L Erkamp
(ML)
Roy van den Berg
(R)
Cretièn J M G Jacobs
(CJMG)
Jelle L Epker
(JL)
Annemiek A Rijkeboer
(AA)
Martha T de Bruin
(MT)
Peter Spronk
(P)
Annelies Draisma
(A)
Dirk Jan Versluis
(DJ)
Lettie A E van den Berg
(LAE)
Marissa Vrolijk-de Mos
(MV)
Judith A Lens
(JA)
D Jannet Mehagnoul-Schipper
(DJ)
Diederik Gommers
(D)
Johan G Lutisan
(JG)
Martijn Hoeksema
(M)
Ralph V Pruijsten
(RV)
Hans Kieft
(H)
Jan Rozendaal
(J)
Fleur Nooteboom
(F)
Dirk P Boer
(DP)
Inge T A Janssen
(ITA)
Laura van Gulik
(L)
M Peter Koetsier
(MP)
Vera M Silderhuis
(VM)
Ronny M Schnabel
(RM)
Ioana Drogt
(I)
Wouter de Ruijter
(W)
Rob J Bosman
(RJ)
Tim Frenzel
(T)
Louise C Urlings-Strop
(LC)
Allard Dijkhuizen
(A)
Ilanit Z Hené
(IZ)
Arthur R de Meijer
(AR)
Jessica W M Holtkamp
(JWM)
Nynke Postma
(N)
Alexander J G H Bindels
(AJGH)
Ronald M J Wesselink
(RMJ)
Eline R van Slobbe-Bijlsma
(ER)
Peter H J van der Voort
(PHJ)
Bob J W Eikemans
(BJW)
Michel G W Barnas
(MGW)
Barbara Festen-Spanjer
(B)
Maarten van Lieshout
(M)
Niels C Gritters
(NC)
Martijn van Tellingen
(M)
Gert B Brunnekreef
(GB)
Joyce Vandeputte
(J)
Tom P J Dormans
(TPJ)
Marga E Hoogendoorn
(ME)
Mart de Graaff
(M)
David Moolenaar
(D)
Auke C Reidinga
(AC)
Jan Jaap Spijkstra
(JJ)
Ruud de Waal
(R)
Informations de copyright
© 2022. The Author(s).
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