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

被引：50

作者：

Dongelmans, Dave A. ^{[1
,2
]}

Termorshuizen, Fabian ^{[1
,3
]}

Brinkman, Sylvia ^{[1
,3
]}

Bakhshi-Raiez, Ferishta ^{[1
,3
]}

Arbous, M. Sesmu ^{[1
,4
]}

de lange, Dylan W. ^{[1
,5
]}

van Bussel, Bas C. T. ^{[6
,7
]}

de Keizer, Nicolette F. ^{[1
,3
]}

机构：

[1] Natl Intens Care Evaluat NICE Fdn, POB 23640, NL-1100 EC Amsterdam, Netherlands

[2] Univ Amsterdam, Amsterdam UMC, Dept Intens Care Med, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands

[3] Univ Amsterdam, Amsterdam UMC, Amsterdam Publ Hlth Res Inst, Dept Med Informat, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands

[4] Leiden Univ, Med Ctr, Dept Intens Care Med, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands

[5] Univ Utrecht, Univ Med Ctr, Dept Intens Care Med, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands

[6] Maastricht Univ Med Ctr, Dept Intens Care Med, P Debyelaan 25, NL-6229 HX Maastricht, Netherlands

[7] Maastricht Univ, Care & Publ Hlth Res Inst CAPHRI, Univ Singel 40, NL-6229 ER Maastricht, Netherlands

来源：

ANNALS OF INTENSIVE CARE | 2022年 / 12卷 / 01期

关键词：

COVID-19; Coronavirus; Mortality; Outcome; Intensive Care; Critical Care; CRITICAL-CARE;

D O I：

10.1186/s13613-021-00978-3

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

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 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 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 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.

引用

页数：10

共 20 条

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