Critical care staffing ratio and outcome of COVID-19 patients requiring intensive care unit admission during the first pandemic wave: a retrospective analysis across Switzerland from the RISC-19-ICU observational cohort
STUDY AIM: The surge of admissions due to severe COVID-19 increased the patients-to-critical care staffing ratio within the ICUs. We investigated whether the daily level of staffing was associated with an increased risk of ICU mortality (primary endpoint), length of stay (LOS), mechanical ventilat...
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| Format: | Article |
| Language: | English |
| Published: |
SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2022-06-01
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| Series: | Swiss Medical Weekly |
| Online Access: | https://smw.ch/index.php/smw/article/view/3220 |
| _version_ | 1826995951853633536 |
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| author | Marie-Madlen Jeitziner André Moser Pedro D Wendel-Garcia Matthias Thomas Exl Stefanie Keiser Reto A. Schuepbach Urs Pietsch Sara Cereghetti Filippo Boroli Julien Marrel Anne-Aylin Sigg Hatem Ksouri Peter Schott Alexander Dullenkopf Isabelle Fleisch Antje Heise Jean-Christophe Laurent Stephan M. Jakob Matthias P. Hilty Yok-Ai Que |
| author_facet | Marie-Madlen Jeitziner André Moser Pedro D Wendel-Garcia Matthias Thomas Exl Stefanie Keiser Reto A. Schuepbach Urs Pietsch Sara Cereghetti Filippo Boroli Julien Marrel Anne-Aylin Sigg Hatem Ksouri Peter Schott Alexander Dullenkopf Isabelle Fleisch Antje Heise Jean-Christophe Laurent Stephan M. Jakob Matthias P. Hilty Yok-Ai Que |
| author_sort | Marie-Madlen Jeitziner |
| collection | DOAJ |
| description |
STUDY AIM: The surge of admissions due to severe COVID-19 increased the patients-to-critical care staffing ratio within the ICUs. We investigated whether the daily level of staffing was associated with an increased risk of ICU mortality (primary endpoint), length of stay (LOS), mechanical ventilation and the evolution of disease (secondary endpoints).
METHODS: We employed a retrospective multicentre analysis of the international Risk Stratification in COVID-19 patients in the ICU (RISC-19-ICU) registry, limited to the period between March 1 and May 31, 2020, and to Switzerland. Hierarchical regression models were used to investigate crude and adjusted effects of the critical care staffing ratio on study endpoints. We adjusted for disease severity and weekly caseload.
RESULTS: Among the 38 participating Swiss ICUs, 17 recorded staffing information. The study population included 437 patients and 2,342 daily assessments of patient-to-critical care staffing ratio. Median of daily patient-to-nurse ratio started at 1.0 [IQR 0.5–1.5; calendar week 9] and peaked at 2.4 (IQR 0.4–2.0; calendar week 16), while the median of daily patient-to-physician ratio started at 4.0 (IQR 2.1–5.0; calendar week 9) and peaked at 6.8 (IQR 6.3–7.3; calendar week 19). Neither the patient-to-nurse (adjusted OR 1.28, 95% CI 0.85–1.93; doubling of ratio) nor the patient-to-physician ratio (adjusted OR 1.07, 95% CI 0.87–1.32; doubling of ratio) were associated with ICU mortality. We found no association of daily critical care staffing on the secondary endpoints in adjusted models.
CONCLUSION: We found no association of reduced availability of critical care staffing resources in Swiss ICUs with overall ICU length of stay nor mortality. Whether long-term outcome of critically ill patients with COVID-19 have been affected remains to be studied.
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| first_indexed | 2024-04-13T04:09:42Z |
| format | Article |
| id | doaj.art-4aedc5ef3f454ce99ea947a853da0e24 |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2025-02-18T09:39:47Z |
| publishDate | 2022-06-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-4aedc5ef3f454ce99ea947a853da0e242024-11-02T17:26:02ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972022-06-01152252610.4414/SMW.2022.w30183Critical care staffing ratio and outcome of COVID-19 patients requiring intensive care unit admission during the first pandemic wave: a retrospective analysis across Switzerland from the RISC-19-ICU observational cohortMarie-Madlen JeitzinerAndré MoserPedro D Wendel-GarciaMatthias Thomas ExlStefanie KeiserReto A. SchuepbachUrs PietschSara CereghettiFilippo BoroliJulien MarrelAnne-Aylin SiggHatem KsouriPeter SchottAlexander DullenkopfIsabelle FleischAntje HeiseJean-Christophe LaurentStephan M. JakobMatthias P. Hilty Yok-Ai Que STUDY AIM: The surge of admissions due to severe COVID-19 increased the patients-to-critical care staffing ratio within the ICUs. We investigated whether the daily level of staffing was associated with an increased risk of ICU mortality (primary endpoint), length of stay (LOS), mechanical ventilation and the evolution of disease (secondary endpoints). METHODS: We employed a retrospective multicentre analysis of the international Risk Stratification in COVID-19 patients in the ICU (RISC-19-ICU) registry, limited to the period between March 1 and May 31, 2020, and to Switzerland. Hierarchical regression models were used to investigate crude and adjusted effects of the critical care staffing ratio on study endpoints. We adjusted for disease severity and weekly caseload. RESULTS: Among the 38 participating Swiss ICUs, 17 recorded staffing information. The study population included 437 patients and 2,342 daily assessments of patient-to-critical care staffing ratio. Median of daily patient-to-nurse ratio started at 1.0 [IQR 0.5–1.5; calendar week 9] and peaked at 2.4 (IQR 0.4–2.0; calendar week 16), while the median of daily patient-to-physician ratio started at 4.0 (IQR 2.1–5.0; calendar week 9) and peaked at 6.8 (IQR 6.3–7.3; calendar week 19). Neither the patient-to-nurse (adjusted OR 1.28, 95% CI 0.85–1.93; doubling of ratio) nor the patient-to-physician ratio (adjusted OR 1.07, 95% CI 0.87–1.32; doubling of ratio) were associated with ICU mortality. We found no association of daily critical care staffing on the secondary endpoints in adjusted models. CONCLUSION: We found no association of reduced availability of critical care staffing resources in Swiss ICUs with overall ICU length of stay nor mortality. Whether long-term outcome of critically ill patients with COVID-19 have been affected remains to be studied. https://smw.ch/index.php/smw/article/view/3220 |
| spellingShingle | Marie-Madlen Jeitziner André Moser Pedro D Wendel-Garcia Matthias Thomas Exl Stefanie Keiser Reto A. Schuepbach Urs Pietsch Sara Cereghetti Filippo Boroli Julien Marrel Anne-Aylin Sigg Hatem Ksouri Peter Schott Alexander Dullenkopf Isabelle Fleisch Antje Heise Jean-Christophe Laurent Stephan M. Jakob Matthias P. Hilty Yok-Ai Que Critical care staffing ratio and outcome of COVID-19 patients requiring intensive care unit admission during the first pandemic wave: a retrospective analysis across Switzerland from the RISC-19-ICU observational cohort Swiss Medical Weekly |
| title | Critical care staffing ratio and outcome of COVID-19 patients requiring intensive care unit admission during the first pandemic wave: a retrospective analysis across Switzerland from the RISC-19-ICU observational cohort |
| title_full | Critical care staffing ratio and outcome of COVID-19 patients requiring intensive care unit admission during the first pandemic wave: a retrospective analysis across Switzerland from the RISC-19-ICU observational cohort |
| title_fullStr | Critical care staffing ratio and outcome of COVID-19 patients requiring intensive care unit admission during the first pandemic wave: a retrospective analysis across Switzerland from the RISC-19-ICU observational cohort |
| title_full_unstemmed | Critical care staffing ratio and outcome of COVID-19 patients requiring intensive care unit admission during the first pandemic wave: a retrospective analysis across Switzerland from the RISC-19-ICU observational cohort |
| title_short | Critical care staffing ratio and outcome of COVID-19 patients requiring intensive care unit admission during the first pandemic wave: a retrospective analysis across Switzerland from the RISC-19-ICU observational cohort |
| title_sort | critical care staffing ratio and outcome of covid 19 patients requiring intensive care unit admission during the first pandemic wave a retrospective analysis across switzerland from the risc 19 icu observational cohort |
| url | https://smw.ch/index.php/smw/article/view/3220 |
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