Six-month post-intensive care outcomes during high and low bed occupancy due to the COVID-19 pandemic: A multicenter prospective cohort study.
<h4>Introduction</h4>The COVID-19 pandemic can be seen as a natural experiment to test how bed occupancy affects post-intensive care unit (ICU) patient's functional outcomes. To compare by bed occupancy the frequency of mental, physical, and cognitive impairments in patients admitte...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0294631&type=printable |
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| author | Ana Castro-Avila Catalina Merino-Osorio Felipe González-Seguel Agustín Camus-Molina Felipe Muñoz-Muñoz Jaime Leppe IMPACCT COVID-19 study group |
| author_facet | Ana Castro-Avila Catalina Merino-Osorio Felipe González-Seguel Agustín Camus-Molina Felipe Muñoz-Muñoz Jaime Leppe IMPACCT COVID-19 study group |
| author_sort | Ana Castro-Avila |
| collection | DOAJ |
| description | <h4>Introduction</h4>The COVID-19 pandemic can be seen as a natural experiment to test how bed occupancy affects post-intensive care unit (ICU) patient's functional outcomes. To compare by bed occupancy the frequency of mental, physical, and cognitive impairments in patients admitted to ICU during the COVID-19 pandemic.<h4>Methods</h4>Prospective cohort of adults mechanically ventilated >48 hours in 19 ICUs from seven Chilean public and private hospitals. Ninety percent of nationwide beds occupied was the cut-off for low versus high bed occupancy. At ICU discharge, 3- and 6-month follow-up, we assessed disability using the World Health Organization Disability Assessment Schedule 2.0. Quality of life, mental, physical, and cognitive outcomes were also evaluated following the core outcome set for acute respiratory failure.<h4>Results</h4>We enrolled 252 participants, 103 (41%) during low and 149 (59%) during high bed occupancy. Patients treated during high occupancy were younger (P50 [P25-P75]: 55 [44-63] vs 61 [51-71]; p<0.001), more likely to be admitted due to COVID-19 (126 [85%] vs 65 [63%]; p<0.001), and have higher education qualification (94 [63%] vs 48 [47%]; p = 0.03). No differences were found in the frequency of at least one mental, physical or cognitive impairment by bed occupancy at ICU discharge (low vs high: 93% vs 91%; p = 0.6), 3-month (74% vs 63%; p = 0.2) and 6-month (57% vs 57%; p = 0.9) follow-up.<h4>Conclusions</h4>There were no differences in post-ICU outcomes between high and low bed occupancy. Most patients (>90%) had at least one mental, physical or cognitive impairment at ICU discharge, which remained high at 6-month follow-up (57%).<h4>Clinical trial registration</h4>NCT04979897 (clinicaltrials.gov). |
| first_indexed | 2024-03-09T00:21:58Z |
| format | Article |
| id | doaj.art-10904fba1475467a875e5acab94bc1d1 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-09T00:21:58Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj.art-10904fba1475467a875e5acab94bc1d12023-12-12T05:34:01ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-011811e029463110.1371/journal.pone.0294631Six-month post-intensive care outcomes during high and low bed occupancy due to the COVID-19 pandemic: A multicenter prospective cohort study.Ana Castro-AvilaCatalina Merino-OsorioFelipe González-SeguelAgustín Camus-MolinaFelipe Muñoz-MuñozJaime LeppeIMPACCT COVID-19 study group<h4>Introduction</h4>The COVID-19 pandemic can be seen as a natural experiment to test how bed occupancy affects post-intensive care unit (ICU) patient's functional outcomes. To compare by bed occupancy the frequency of mental, physical, and cognitive impairments in patients admitted to ICU during the COVID-19 pandemic.<h4>Methods</h4>Prospective cohort of adults mechanically ventilated >48 hours in 19 ICUs from seven Chilean public and private hospitals. Ninety percent of nationwide beds occupied was the cut-off for low versus high bed occupancy. At ICU discharge, 3- and 6-month follow-up, we assessed disability using the World Health Organization Disability Assessment Schedule 2.0. Quality of life, mental, physical, and cognitive outcomes were also evaluated following the core outcome set for acute respiratory failure.<h4>Results</h4>We enrolled 252 participants, 103 (41%) during low and 149 (59%) during high bed occupancy. Patients treated during high occupancy were younger (P50 [P25-P75]: 55 [44-63] vs 61 [51-71]; p<0.001), more likely to be admitted due to COVID-19 (126 [85%] vs 65 [63%]; p<0.001), and have higher education qualification (94 [63%] vs 48 [47%]; p = 0.03). No differences were found in the frequency of at least one mental, physical or cognitive impairment by bed occupancy at ICU discharge (low vs high: 93% vs 91%; p = 0.6), 3-month (74% vs 63%; p = 0.2) and 6-month (57% vs 57%; p = 0.9) follow-up.<h4>Conclusions</h4>There were no differences in post-ICU outcomes between high and low bed occupancy. Most patients (>90%) had at least one mental, physical or cognitive impairment at ICU discharge, which remained high at 6-month follow-up (57%).<h4>Clinical trial registration</h4>NCT04979897 (clinicaltrials.gov).https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0294631&type=printable |
| spellingShingle | Ana Castro-Avila Catalina Merino-Osorio Felipe González-Seguel Agustín Camus-Molina Felipe Muñoz-Muñoz Jaime Leppe IMPACCT COVID-19 study group Six-month post-intensive care outcomes during high and low bed occupancy due to the COVID-19 pandemic: A multicenter prospective cohort study. PLoS ONE |
| title | Six-month post-intensive care outcomes during high and low bed occupancy due to the COVID-19 pandemic: A multicenter prospective cohort study. |
| title_full | Six-month post-intensive care outcomes during high and low bed occupancy due to the COVID-19 pandemic: A multicenter prospective cohort study. |
| title_fullStr | Six-month post-intensive care outcomes during high and low bed occupancy due to the COVID-19 pandemic: A multicenter prospective cohort study. |
| title_full_unstemmed | Six-month post-intensive care outcomes during high and low bed occupancy due to the COVID-19 pandemic: A multicenter prospective cohort study. |
| title_short | Six-month post-intensive care outcomes during high and low bed occupancy due to the COVID-19 pandemic: A multicenter prospective cohort study. |
| title_sort | six month post intensive care outcomes during high and low bed occupancy due to the covid 19 pandemic a multicenter prospective cohort study |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0294631&type=printable |
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