Comparison of patient characteristics and long-term mortality between transferred and non-transferred COVID-19 patients in Dutch intensive care units: A national cohort study.
COVID-19
intensive care unit
intrahospital transfer
mortality
severity of illness
Journal
Acta anaesthesiologica Scandinavica
ISSN: 1399-6576
Titre abrégé: Acta Anaesthesiol Scand
Pays: England
ID NLM: 0370270
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
revised:
17
06
2022
received:
10
11
2021
accepted:
23
06
2022
pubmed:
30
8
2022
medline:
20
9
2022
entrez:
29
8
2022
Statut:
ppublish
Résumé
COVID-19 patients were often transferred to other intensive care units (ICUs) to prevent that ICUs would reach their maximum capacity. However, transferring ICU patients is not free of risk. We aim to compare the characteristics and outcomes of transferred versus non-transferred COVID-19 ICU patients in the Netherlands. We included adult COVID-19 patients admitted to Dutch ICUs between March 1, 2020 and July 1, 2021. We compared the patient characteristics and outcomes of non-transferred and transferred patients and used a Directed Acyclic Graph to identify potential confounders in the relationship between transfer and mortality. We used these confounders in a Cox regression model with left truncation at the day of transfer to analyze the effect of transfers on mortality during the 180 days after ICU admission. We included 10,209 patients: 7395 non-transferred and 2814 (27.6%) transferred patients. In both groups, the median age was 64 years. Transferred patients were mostly ventilated at ICU admission (83.7% vs. 56.2%) and included a larger proportion of low-risk patients (70.3% vs. 66.5% with mortality risk <30%). After adjusting for age, APACHE IV mortality probability, BMI, mechanical ventilation, and vasoactive medication use, the hazard of mortality during the first 180 days was similar for transferred patients compared to non-transferred patients (HR [95% CI] = 0.99 [0.91-1.08]). Transferred COVID-19 patients are more often mechanically ventilated and are less severely ill compared to non-transferred patients. Furthermore, transferring critically ill COVID-19 patients in the Netherlands is not associated with mortality during the first 180 days after ICU admission.
Sections du résumé
BACKGROUND
COVID-19 patients were often transferred to other intensive care units (ICUs) to prevent that ICUs would reach their maximum capacity. However, transferring ICU patients is not free of risk. We aim to compare the characteristics and outcomes of transferred versus non-transferred COVID-19 ICU patients in the Netherlands.
METHODS
We included adult COVID-19 patients admitted to Dutch ICUs between March 1, 2020 and July 1, 2021. We compared the patient characteristics and outcomes of non-transferred and transferred patients and used a Directed Acyclic Graph to identify potential confounders in the relationship between transfer and mortality. We used these confounders in a Cox regression model with left truncation at the day of transfer to analyze the effect of transfers on mortality during the 180 days after ICU admission.
RESULTS
We included 10,209 patients: 7395 non-transferred and 2814 (27.6%) transferred patients. In both groups, the median age was 64 years. Transferred patients were mostly ventilated at ICU admission (83.7% vs. 56.2%) and included a larger proportion of low-risk patients (70.3% vs. 66.5% with mortality risk <30%). After adjusting for age, APACHE IV mortality probability, BMI, mechanical ventilation, and vasoactive medication use, the hazard of mortality during the first 180 days was similar for transferred patients compared to non-transferred patients (HR [95% CI] = 0.99 [0.91-1.08]).
CONCLUSIONS
Transferred COVID-19 patients are more often mechanically ventilated and are less severely ill compared to non-transferred patients. Furthermore, transferring critically ill COVID-19 patients in the Netherlands is not associated with mortality during the first 180 days after ICU admission.
Identifiants
pubmed: 36031794
doi: 10.1111/aas.14129
pmc: PMC9539143
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1107-1115Investigateurs
M S Arbous
(MS)
M G W Barnas
(MGW)
A J G H Bindels
(AJGH)
D P Boer
(DP)
R J Bosman
(RJ)
G B Brunnekreef
(GB)
M Th de Bruin
(MT)
M de Graaff
(M)
R M de Jong
(RM)
A R de Meijer
(AR)
W de Ruijter
(W)
R de Waal
(R)
A Dijkhuizen
(A)
T P J Dormans
(TPJ)
A Draisma
(A)
I Drogt
(I)
B J W Eikemans
(BJW)
P W G Elbers
(PWG)
J L Epker
(JL)
M L Erkamp
(ML)
B Festen-Spanjer
(B)
T Frenzel
(T)
D Gommers
(D)
N C Gritters
(NC)
I Z Hené
(IZ)
M Hoeksema
(M)
J W M Holtkamp
(JWM)
M E Hoogendoorn
(ME)
A P I Houwink
(API)
C J M G Jacobs
(CJMG)
I T A Janssen
(ITA)
H Kieft
(H)
M P Koetsier
(MP)
T J J Koning
(TJJ)
N Kusadasi
(N)
J A Lens
(JA)
J G Lutisan
(JG)
D J Mehagnoul-Schipper
(DJ)
D Moolenaar
(D)
F Nooteboom
(F)
R V Pruijsten
(RV)
D Ramnarain
(D)
A C Reidinga
(AC)
E Rengers
(E)
A A Rijkeboer
(AA)
F W Rozendaal
(FW)
R M Schnabel
(RM)
V M Silderhuis
(VM)
J J Spijkstra
(JJ)
P Spronk
(P)
L F Te Velde
(LF)
L C Urlings-Strop
(LC)
B C T van Bussel
(BCT)
A E van den Berg
(AE)
R van den Berg
(R)
P H J van der Voort
(PHJ)
E M van Driel
(EM)
L van Gulik
(L)
F M van Iersel
(FM)
M van Lieshout
(M)
E R van Slobbe-Bijlsma
(ER)
M van Tellingen
(M)
J Vandeputte
(J)
D P Verbiest
(DP)
D J Versluis
(DJ)
E Verweij
(E)
M Vrolijk-de Mos
(MV)
R M J Wesselink
(RMJ)
Informations de copyright
© 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.
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