Predicting factors associated with prolonged intensive care unit stay of patients with COVID-19
Background Predicting the length of stay (LOS) for coronavirus disease 2019 (COVID-19) patients in the intensive care unit (ICU) is essential for efficient use of ICU resources. We analyzed the clinical characteristics of patients with severe COVID-19 based on their clinical care and determined the...
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| Format: | Article |
| Language: | English |
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Korean Society of Critical Care Medicine
2023-02-01
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| Series: | Acute and Critical Care |
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| Online Access: | http://accjournal.org/upload/pdf/acc-2022-01235.pdf |
| _version_ | 1827942540550078464 |
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| author | Won Ho Han Jae Hoon Lee June Young Chun Young Ju Choi Youseok Kim Mira Han Jee Hee Kim |
| author_facet | Won Ho Han Jae Hoon Lee June Young Chun Young Ju Choi Youseok Kim Mira Han Jee Hee Kim |
| author_sort | Won Ho Han |
| collection | DOAJ |
| description | Background Predicting the length of stay (LOS) for coronavirus disease 2019 (COVID-19) patients in the intensive care unit (ICU) is essential for efficient use of ICU resources. We analyzed the clinical characteristics of patients with severe COVID-19 based on their clinical care and determined the predictive factors associated with prolonged LOS. Methods We included 96 COVID-19 patients who received oxygen therapy at a high-flow nasal cannula level or above after ICU admission during March 2021 to February 2022. The demographic characteristics at the time of ICU admission and results of severity analysis (Sequential Organ Failure Assessment [SOFA], Acute Physiology and Chronic Health Evaluation [APACHE] II), blood tests, and ICU treatments were analyzed using a logistic regression model. Additionally, blood tests (C-reactive protein, D-dimer, and the PaO2 to FiO2 ratio [P/F ratio]) were performed on days 3 and 5 of ICU admission to identify factors associated with prolonged LOS. Results Univariable analyses showed statistically significant results for SOFA score at the time of ICU admission, C-reactive protein level, high-dose steroids, mechanical ventilation (MV) care, continuous renal replacement therapy, extracorporeal membrane oxygenation, and prone position. Multivariable analysis showed that MV care and P/F ratio on hospital day 5 were independent factors for prolonged ICU LOS. For D-dimer, no significant variation was observed at admission; however, after days 3 and 5 days of admission, significant between-group variation was detected. Conclusions MV care and P/F ratio on hospital day 5 are independent factors that can predict prolonged LOS for COVID-19 patients. |
| first_indexed | 2024-03-13T10:01:16Z |
| format | Article |
| id | doaj.art-6aac197cd1804551affc80c008ec339e |
| institution | Directory Open Access Journal |
| issn | 2586-6052 2586-6060 |
| language | English |
| last_indexed | 2024-03-13T10:01:16Z |
| publishDate | 2023-02-01 |
| publisher | Korean Society of Critical Care Medicine |
| record_format | Article |
| series | Acute and Critical Care |
| spelling | doaj.art-6aac197cd1804551affc80c008ec339e2023-05-23T05:34:55ZengKorean Society of Critical Care MedicineAcute and Critical Care2586-60522586-60602023-02-01381414810.4266/acc.2022.012351443Predicting factors associated with prolonged intensive care unit stay of patients with COVID-19Won Ho Han0Jae Hoon Lee1June Young Chun2Young Ju Choi3Youseok Kim4Mira Han5Jee Hee Kim6 Department of Critical Care Medicine, National Cancer Center, Goyang, Korea Department of Critical Care Medicine, National Cancer Center, Goyang, Korea Department of Internal Medicine, National Cancer Center, Goyang, Korea Department of Internal Medicine, National Cancer Center, Goyang, Korea Department of Critical Care Medicine, National Cancer Center, Goyang, Korea Biostatistics Collaboration Team, National Cancer Center, Goyang, Korea Department of Critical Care Medicine, National Cancer Center, Goyang, KoreaBackground Predicting the length of stay (LOS) for coronavirus disease 2019 (COVID-19) patients in the intensive care unit (ICU) is essential for efficient use of ICU resources. We analyzed the clinical characteristics of patients with severe COVID-19 based on their clinical care and determined the predictive factors associated with prolonged LOS. Methods We included 96 COVID-19 patients who received oxygen therapy at a high-flow nasal cannula level or above after ICU admission during March 2021 to February 2022. The demographic characteristics at the time of ICU admission and results of severity analysis (Sequential Organ Failure Assessment [SOFA], Acute Physiology and Chronic Health Evaluation [APACHE] II), blood tests, and ICU treatments were analyzed using a logistic regression model. Additionally, blood tests (C-reactive protein, D-dimer, and the PaO2 to FiO2 ratio [P/F ratio]) were performed on days 3 and 5 of ICU admission to identify factors associated with prolonged LOS. Results Univariable analyses showed statistically significant results for SOFA score at the time of ICU admission, C-reactive protein level, high-dose steroids, mechanical ventilation (MV) care, continuous renal replacement therapy, extracorporeal membrane oxygenation, and prone position. Multivariable analysis showed that MV care and P/F ratio on hospital day 5 were independent factors for prolonged ICU LOS. For D-dimer, no significant variation was observed at admission; however, after days 3 and 5 days of admission, significant between-group variation was detected. Conclusions MV care and P/F ratio on hospital day 5 are independent factors that can predict prolonged LOS for COVID-19 patients.http://accjournal.org/upload/pdf/acc-2022-01235.pdfcovid-19d-dimerintensive care unitlength of staymechanical ventilation |
| spellingShingle | Won Ho Han Jae Hoon Lee June Young Chun Young Ju Choi Youseok Kim Mira Han Jee Hee Kim Predicting factors associated with prolonged intensive care unit stay of patients with COVID-19 Acute and Critical Care covid-19 d-dimer intensive care unit length of stay mechanical ventilation |
| title | Predicting factors associated with prolonged intensive care unit stay of patients with COVID-19 |
| title_full | Predicting factors associated with prolonged intensive care unit stay of patients with COVID-19 |
| title_fullStr | Predicting factors associated with prolonged intensive care unit stay of patients with COVID-19 |
| title_full_unstemmed | Predicting factors associated with prolonged intensive care unit stay of patients with COVID-19 |
| title_short | Predicting factors associated with prolonged intensive care unit stay of patients with COVID-19 |
| title_sort | predicting factors associated with prolonged intensive care unit stay of patients with covid 19 |
| topic | covid-19 d-dimer intensive care unit length of stay mechanical ventilation |
| url | http://accjournal.org/upload/pdf/acc-2022-01235.pdf |
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