Abstract
Objectives: During the COVID-19 pandemic, the risk of collapse for the health system created great difficulties. We will demonstrate that intermediate respiratory care units (IRCU) provide adequate management of patients with non-invasive respiratory support, which is particularly important for patients with SARS-CoV-2 pneumonia. Methods: A prospective observational study of patients with COVID-19 admitted to the ICU of a tertiary hospital. Sociodemographic data, comorbidities, pharmacological, respiratory support, laboratory and blood gas variables were collected. The overall cost of the unit was subsequently analyzed. Results: 991 patients were admitted, 56 to the IRCU (from a of 81 admitted to the critical care unit). Mean age was 65 years (SD 12.8), Barthel index 75 (SD 8.3), Charlson comorbidity index 3.1 (SD 2.2), HTN 27%, COPD 89% and obesity 24%. A significant relationship ( p < 0.05) with higher mortality was noted for the following parameters: fever greater than or equal to 39 °C [OR 5.6; 95% CI (1.2-2.7); p = 0.020], protocolized pharmacological treatment [OR 0.3; 95% CI (0.1-0.9); p = 0.023] and IOI [OR 3.7; 95% CI (1.1-12.3); p = 0.025]. NIMV had less of a negative impact [OR 1.8; 95% CI (0.4-8.4); p = 0.423] than IOI. The total cost of the IRCU amounted to €66,233. The cost per day of stay in the IRCU was €164 per patient. The total cost avoided was €214,865. Conclusions: The pandemic has highlighted the importance of IRCUs in facilitating the management of a high patient volume. The treatment carried out in IRCUs is effective and efficient, reducing both admissions to and stays in the ICU.
Keywords: COVID; ICU; cost-effectiveness; respiratory care.
【저자키워드】 ICU, COVID, cost-effectiveness, respiratory care., 【초록키워드】 Treatment, pandemic, Critical care, Mortality, Pneumonia, prospective observational study, COVID-19 pandemic, obesity, hospital, Comorbidities, Comorbidity, risk, COPD, Laboratory, management, Fever, Patient, age, health system, Admission, Blood, Respiratory Support, pharmacological treatment, Volume, Respiratory care, Non-invasive respiratory support, 95% CI, NIMV, variable, pharmacological, effective, greater, analyzed, collected, carried, per day, less, reducing, patients with COVID-19, patients with SARS-CoV-2, 【제목키워드】 COVID-19, intensive care unit, respiratory, unit, intermediate,