Assessment of 28-Day In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019: An International Cohort Study
IMPORTANCE:. Factors associated with mortality in coronavirus disease 2019 patients on invasive mechanical ventilation are still not fully elucidated. OBJECTIVES:. To identify patient-level parameters, readily available at the bedside, associated with the risk of in-hospital mortality within 28 days...
Guardado en:
| Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Wolters Kluwer
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/33365c4eda564e4b8e636b3f5c02ec63 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:33365c4eda564e4b8e636b3f5c02ec63 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:33365c4eda564e4b8e636b3f5c02ec632021-11-25T07:56:59ZAssessment of 28-Day In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019: An International Cohort Study2639-802810.1097/CCE.0000000000000567https://doaj.org/article/33365c4eda564e4b8e636b3f5c02ec632021-11-01T00:00:00Zhttp://journals.lww.com/10.1097/CCE.0000000000000567https://doaj.org/toc/2639-8028IMPORTANCE:. Factors associated with mortality in coronavirus disease 2019 patients on invasive mechanical ventilation are still not fully elucidated. OBJECTIVES:. To identify patient-level parameters, readily available at the bedside, associated with the risk of in-hospital mortality within 28 days from commencement of invasive mechanical ventilation or coronavirus disease 2019. DESIGN, SETTING, AND PARTICIPANTS:. Prospective observational cohort study by the global Coronavirus Disease 2019 Critical Care Consortium. Patients with laboratory-confirmed coronavirus disease 2019 requiring invasive mechanical ventilation from February 2, 2020, to May 15, 2021. MAIN OUTCOMES AND MEASURES:. Patient characteristics and clinical data were assessed upon ICU admission, the commencement of invasive mechanical ventilation and for 28 days thereafter. We primarily aimed to identify time-independent and time-dependent risk factors for 28-day invasive mechanical ventilation mortality. RESULTS:. One-thousand five-hundred eighty-seven patients were included in the survival analysis; 588 patients died in hospital within 28 days of commencing invasive mechanical ventilation (37%). Cox-regression analysis identified associations between the hazard of 28-day invasive mechanical ventilation mortality with age (hazard ratio, 1.26 per 10-yr increase in age; 95% CI, 1.16–1.37; p < 0.001), positive end-expiratory pressure upon commencement of invasive mechanical ventilation (hazard ratio, 0.81 per 5 cm H2O increase; 95% CI, 0.67–0.97; p = 0.02). Time-dependent parameters associated with 28-day invasive mechanical ventilation mortality were serum creatinine (hazard ratio, 1.28 per doubling; 95% CI, 1.15–1.41; p < 0.001), lactate (hazard ratio, 1.22 per doubling; 95% CI, 1.11–1.34; p < 0.001), Paco2 (hazard ratio, 1.63 per doubling; 95% CI, 1.19–2.25; p < 0.001), pH (hazard ratio, 0.89 per 0.1 increase; 95% CI, 0.8–14; p = 0.041), Pao2/Fio2 (hazard ratio, 0.58 per doubling; 95% CI, 0.52–0.66; p < 0.001), and mean arterial pressure (hazard ratio, 0.92 per 10 mm Hg increase; 95% CI, 0.88–0.97; p = 0.003). CONCLUSIONS AND RELEVANCE:. This international study suggests that in patients with coronavirus disease 2019 on invasive mechanical ventilation, older age and clinically relevant variables monitored at baseline or sequentially during the course of invasive mechanical ventilation are associated with 28-day invasive mechanical ventilation mortality hazard. Further investigation is warranted to validate any causative roles these parameters might play in influencing clinical outcomes.Gianluigi Li Bassi, MD, PhDJacky Y. Suen, BSc, PhDNicole White, PhDHeidi J. Dalton, MD, MCCMJonathon Fanning, BSc, MBBS, PhD, FANZCA, FCICMAmanda Corley, RNSally Shrapnel, MBBS, BMedSc, MSc, PhD, FRACGPSamuel Hinton, PhDSimon Forsyth, PhDRex Parsons, BSc, MMedStatsJohn G. Laffey, MDEddy Fan, MD, PhDRobert Bartlett, MDDaniel Brodie, MDAidan Burrell, MD, PhDDavide Chiumello, MDAlyaa Elhazmi, MDGiacomo Grasselli, MDCarol Hodgson, PT, PhDShingo Ichiba, MDCarlos Luna, MDEva Marwali, MDLaura Merson, BscSrinivas Murthy, MDAlistair Nichol, MD, PhDMauro Panigada, MDPaolo Pelosi, MD, FERSAntoni Torres, MD, PhD, FERSPauline Yeung Ng, MDMark Ogino, MDJohn F. Fraser, MBChB, PhD, FRCP(Glas), FFARCSI, FRCA, FCICMon behalf of the COVID-19 Critical Care ConsortiumWolters KluwerarticleMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENCritical Care Explorations, Vol 3, Iss 11, p e0567 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 |
| spellingShingle |
Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Gianluigi Li Bassi, MD, PhD Jacky Y. Suen, BSc, PhD Nicole White, PhD Heidi J. Dalton, MD, MCCM Jonathon Fanning, BSc, MBBS, PhD, FANZCA, FCICM Amanda Corley, RN Sally Shrapnel, MBBS, BMedSc, MSc, PhD, FRACGP Samuel Hinton, PhD Simon Forsyth, PhD Rex Parsons, BSc, MMedStats John G. Laffey, MD Eddy Fan, MD, PhD Robert Bartlett, MD Daniel Brodie, MD Aidan Burrell, MD, PhD Davide Chiumello, MD Alyaa Elhazmi, MD Giacomo Grasselli, MD Carol Hodgson, PT, PhD Shingo Ichiba, MD Carlos Luna, MD Eva Marwali, MD Laura Merson, Bsc Srinivas Murthy, MD Alistair Nichol, MD, PhD Mauro Panigada, MD Paolo Pelosi, MD, FERS Antoni Torres, MD, PhD, FERS Pauline Yeung Ng, MD Mark Ogino, MD John F. Fraser, MBChB, PhD, FRCP(Glas), FFARCSI, FRCA, FCICM on behalf of the COVID-19 Critical Care Consortium Assessment of 28-Day In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019: An International Cohort Study |
| description |
IMPORTANCE:. Factors associated with mortality in coronavirus disease 2019 patients on invasive mechanical ventilation are still not fully elucidated.
OBJECTIVES:. To identify patient-level parameters, readily available at the bedside, associated with the risk of in-hospital mortality within 28 days from commencement of invasive mechanical ventilation or coronavirus disease 2019.
DESIGN, SETTING, AND PARTICIPANTS:. Prospective observational cohort study by the global Coronavirus Disease 2019 Critical Care Consortium. Patients with laboratory-confirmed coronavirus disease 2019 requiring invasive mechanical ventilation from February 2, 2020, to May 15, 2021.
MAIN OUTCOMES AND MEASURES:. Patient characteristics and clinical data were assessed upon ICU admission, the commencement of invasive mechanical ventilation and for 28 days thereafter. We primarily aimed to identify time-independent and time-dependent risk factors for 28-day invasive mechanical ventilation mortality.
RESULTS:. One-thousand five-hundred eighty-seven patients were included in the survival analysis; 588 patients died in hospital within 28 days of commencing invasive mechanical ventilation (37%). Cox-regression analysis identified associations between the hazard of 28-day invasive mechanical ventilation mortality with age (hazard ratio, 1.26 per 10-yr increase in age; 95% CI, 1.16–1.37; p < 0.001), positive end-expiratory pressure upon commencement of invasive mechanical ventilation (hazard ratio, 0.81 per 5 cm H2O increase; 95% CI, 0.67–0.97; p = 0.02). Time-dependent parameters associated with 28-day invasive mechanical ventilation mortality were serum creatinine (hazard ratio, 1.28 per doubling; 95% CI, 1.15–1.41; p < 0.001), lactate (hazard ratio, 1.22 per doubling; 95% CI, 1.11–1.34; p < 0.001), Paco2 (hazard ratio, 1.63 per doubling; 95% CI, 1.19–2.25; p < 0.001), pH (hazard ratio, 0.89 per 0.1 increase; 95% CI, 0.8–14; p = 0.041), Pao2/Fio2 (hazard ratio, 0.58 per doubling; 95% CI, 0.52–0.66; p < 0.001), and mean arterial pressure (hazard ratio, 0.92 per 10 mm Hg increase; 95% CI, 0.88–0.97; p = 0.003).
CONCLUSIONS AND RELEVANCE:. This international study suggests that in patients with coronavirus disease 2019 on invasive mechanical ventilation, older age and clinically relevant variables monitored at baseline or sequentially during the course of invasive mechanical ventilation are associated with 28-day invasive mechanical ventilation mortality hazard. Further investigation is warranted to validate any causative roles these parameters might play in influencing clinical outcomes. |
| format |
article |
| author |
Gianluigi Li Bassi, MD, PhD Jacky Y. Suen, BSc, PhD Nicole White, PhD Heidi J. Dalton, MD, MCCM Jonathon Fanning, BSc, MBBS, PhD, FANZCA, FCICM Amanda Corley, RN Sally Shrapnel, MBBS, BMedSc, MSc, PhD, FRACGP Samuel Hinton, PhD Simon Forsyth, PhD Rex Parsons, BSc, MMedStats John G. Laffey, MD Eddy Fan, MD, PhD Robert Bartlett, MD Daniel Brodie, MD Aidan Burrell, MD, PhD Davide Chiumello, MD Alyaa Elhazmi, MD Giacomo Grasselli, MD Carol Hodgson, PT, PhD Shingo Ichiba, MD Carlos Luna, MD Eva Marwali, MD Laura Merson, Bsc Srinivas Murthy, MD Alistair Nichol, MD, PhD Mauro Panigada, MD Paolo Pelosi, MD, FERS Antoni Torres, MD, PhD, FERS Pauline Yeung Ng, MD Mark Ogino, MD John F. Fraser, MBChB, PhD, FRCP(Glas), FFARCSI, FRCA, FCICM on behalf of the COVID-19 Critical Care Consortium |
| author_facet |
Gianluigi Li Bassi, MD, PhD Jacky Y. Suen, BSc, PhD Nicole White, PhD Heidi J. Dalton, MD, MCCM Jonathon Fanning, BSc, MBBS, PhD, FANZCA, FCICM Amanda Corley, RN Sally Shrapnel, MBBS, BMedSc, MSc, PhD, FRACGP Samuel Hinton, PhD Simon Forsyth, PhD Rex Parsons, BSc, MMedStats John G. Laffey, MD Eddy Fan, MD, PhD Robert Bartlett, MD Daniel Brodie, MD Aidan Burrell, MD, PhD Davide Chiumello, MD Alyaa Elhazmi, MD Giacomo Grasselli, MD Carol Hodgson, PT, PhD Shingo Ichiba, MD Carlos Luna, MD Eva Marwali, MD Laura Merson, Bsc Srinivas Murthy, MD Alistair Nichol, MD, PhD Mauro Panigada, MD Paolo Pelosi, MD, FERS Antoni Torres, MD, PhD, FERS Pauline Yeung Ng, MD Mark Ogino, MD John F. Fraser, MBChB, PhD, FRCP(Glas), FFARCSI, FRCA, FCICM on behalf of the COVID-19 Critical Care Consortium |
| author_sort |
Gianluigi Li Bassi, MD, PhD |
| title |
Assessment of 28-Day In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019: An International Cohort Study |
| title_short |
Assessment of 28-Day In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019: An International Cohort Study |
| title_full |
Assessment of 28-Day In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019: An International Cohort Study |
| title_fullStr |
Assessment of 28-Day In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019: An International Cohort Study |
| title_full_unstemmed |
Assessment of 28-Day In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019: An International Cohort Study |
| title_sort |
assessment of 28-day in-hospital mortality in mechanically ventilated patients with coronavirus disease 2019: an international cohort study |
| publisher |
Wolters Kluwer |
| publishDate |
2021 |
| url |
https://doaj.org/article/33365c4eda564e4b8e636b3f5c02ec63 |
| work_keys_str_mv |
AT gianluigilibassimdphd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT jackyysuenbscphd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT nicolewhitephd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT heidijdaltonmdmccm assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT jonathonfanningbscmbbsphdfanzcafcicm assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT amandacorleyrn assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT sallyshrapnelmbbsbmedscmscphdfracgp assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT samuelhintonphd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT simonforsythphd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT rexparsonsbscmmedstats assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT johnglaffeymd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT eddyfanmdphd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT robertbartlettmd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT danielbrodiemd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT aidanburrellmdphd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT davidechiumellomd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT alyaaelhazmimd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT giacomograssellimd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT carolhodgsonptphd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT shingoichibamd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT carloslunamd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT evamarwalimd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT lauramersonbsc assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT srinivasmurthymd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT alistairnicholmdphd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT mauropanigadamd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT paolopelosimdfers assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT antonitorresmdphdfers assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT paulineyeungngmd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT markoginomd assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT johnffrasermbchbphdfrcpglasffarcsifrcafcicm assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy AT onbehalfofthecovid19criticalcareconsortium assessmentof28dayinhospitalmortalityinmechanicallyventilatedpatientswithcoronavirusdisease2019aninternationalcohortstudy |
| _version_ |
1718413610658562048 |