Abstract
Rationale: During the first wave of the coronavirus disease (COVID-19) pandemic in New York City, the number of mechanically ventilated COVID-19 patients rapidly surpassed the capacity of traditional intensive care units (ICUs), resulting in health systems utilizing other areas as expanded ICUs to provide critical care. Objectives: To evaluate the mortality of patients admitted to expanded ICUs compared with those admitted to traditional ICUs. Methods: Multicenter, retrospective, cohort study of mechanically ventilated patients with COVID-19 admitted to the ICUs at 11 Northwell Health hospitals in the greater New York City area between March 1, 2020 and April 30, 2020. Primary outcome was in-hospital mortality up to 28 days after intubation of COVID-19 patients. Results: Among 1,966 mechanically ventilated patients with COVID-19, 1,198 (61%) died within 28 days after intubation, 46 (2%) were transferred to other hospitals outside of the Northwell Health system, 722 (37%) survived in the hospital until 28 days or were discharged after recovery. The risk of mortality of mechanically ventilated patients admitted to expanded ICUs was not different from those admitted to traditional ICUs (hazard ratio [HR], 1.07; 95% confidence interval [CI], 0.95-1.20; P = 0.28), while hospital occupancy for critically ill patients itself was associated with increased risk of mortality (HR, 1.28; 95% CI, 1.12-1.45; P < 0.001). Conclusions: Although increased hospital occupancy for critically ill patients itself was associated with increased mortality, the risk of 28-day in-hospital mortality of mechanically ventilated patients with COVID-19 who were admitted to expanded ICUs was not different from those admitted to traditional ICUs.
Keywords: COVID pandemic; expanded ICU; hospital occupancy for critically ill patients; mechanically ventilated COVID-19 patients; traditional ICU.
【저자키워드】 COVID pandemic, expanded ICU, hospital occupancy for critically ill patients, mechanically ventilated COVID-19 patients, traditional ICU., 【초록키워드】 COVID-19, coronavirus disease, pandemic, Critical care, Mortality, hospital, intensive care unit, intubation, risk, outcome, New York City, ICU, cohort study, COVID, Critically ill, Patient, health system, First wave, in-hospital mortality, COVID-19 patients, retrospective, COVID-19 patient, Critically ill patient, 95% CI, 95% confidence interval, increased risk, hazard ratio, ICUs, increased mortality, mechanically ventilated, greater, resulting, evaluate, died, not different, discharged, survived, mechanically ventilated patient, surpassed, transferred, with COVID-19, 【제목키워드】 COVID-19, intensive care unit, New York, Traditional,