High incidence of barotrauma in patients admitted with COVID-19 to ICU and associated mortality in rural Appalachia: An observational study
<h4>Objectives</h4> To assess the incidence of barotrauma and its impact on mortality in COVID-19 patients admitted to ICU. <h4>Design</h4> Single-center retrospective study of consecutive COVID-19 patients admitted to a rural tertiary-care ICU. The primary outcomes were inci...
| Main Authors: | , , , , , , , |
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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://www.ncbi.nlm.nih.gov/pmc/articles/PMC9997869/?tool=EBI |
| _version_ | 1811154284674285568 |
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| author | Sunil Sharma Varun Badami Edward Rojas Rahul Sangani Kyle Chapman Carlo Avalon Austin King Sijin Wen |
| author_facet | Sunil Sharma Varun Badami Edward Rojas Rahul Sangani Kyle Chapman Carlo Avalon Austin King Sijin Wen |
| author_sort | Sunil Sharma |
| collection | DOAJ |
| description | <h4>Objectives</h4> To assess the incidence of barotrauma and its impact on mortality in COVID-19 patients admitted to ICU. <h4>Design</h4> Single-center retrospective study of consecutive COVID-19 patients admitted to a rural tertiary-care ICU. The primary outcomes were incidence of barotrauma in COVID-19 patients and all-cause 30-day mortality. Secondary outcomes were the length of stay (LOS) in the hospital and ICU. Kaplan-Meier method and log-rank test were used in the survival data analysis. <h4>Setting</h4> Medical ICU, West Virginia University Hospital (WVUH), USA. <h4>Patients</h4> All adult patients were admitted to the ICU for acute hypoxic respiratory failure due to coronavirus disease 2019 between September 1, 2020, and December 31, 2020. Historical controls were ARDS patients admitted pre-COVID. <h4>Intervention</h4> Not applicable. <h4>Measurements and main results</h4> One hundred and sixty-five consecutive patients with COVID-19 were admitted to the ICU during the defined period, compared to 39 historical non-COVID controls. The overall incidence of barotrauma in COVID-19 patients was 37/165 (22.4%) compared to 4/39 (10.3%) in the control group. Patients with COVID-19 and barotrauma had a significantly worse survival (HR = 1.56, p = 0.047) compared to controls. In those requiring invasive mechanical ventilation, the COVID group also had significantly higher rates of barotrauma (OR 3.1, p = 0.03) and worse all-cause mortality (OR 2.21, p = 0.018). COVID-19 with barotrauma had significantly higher LOS in the ICU and the hospital. <h4>Conclusions</h4> Our data on critically ill COVID-19 patients admitted to the ICU shows a high incidence of barotrauma and mortality compared to the controls. Additionally, we report a high incidence of barotrauma even in non-ventilated ICU patients. |
| first_indexed | 2024-04-10T04:14:11Z |
| format | Article |
| id | doaj.art-c6da7dae59444cdf94c9aeb4d0c5c2c1 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-10T04:14:11Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-c6da7dae59444cdf94c9aeb4d0c5c2c12023-03-12T05:32:32ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01183High incidence of barotrauma in patients admitted with COVID-19 to ICU and associated mortality in rural Appalachia: An observational studySunil SharmaVarun BadamiEdward RojasRahul SanganiKyle ChapmanCarlo AvalonAustin KingSijin Wen<h4>Objectives</h4> To assess the incidence of barotrauma and its impact on mortality in COVID-19 patients admitted to ICU. <h4>Design</h4> Single-center retrospective study of consecutive COVID-19 patients admitted to a rural tertiary-care ICU. The primary outcomes were incidence of barotrauma in COVID-19 patients and all-cause 30-day mortality. Secondary outcomes were the length of stay (LOS) in the hospital and ICU. Kaplan-Meier method and log-rank test were used in the survival data analysis. <h4>Setting</h4> Medical ICU, West Virginia University Hospital (WVUH), USA. <h4>Patients</h4> All adult patients were admitted to the ICU for acute hypoxic respiratory failure due to coronavirus disease 2019 between September 1, 2020, and December 31, 2020. Historical controls were ARDS patients admitted pre-COVID. <h4>Intervention</h4> Not applicable. <h4>Measurements and main results</h4> One hundred and sixty-five consecutive patients with COVID-19 were admitted to the ICU during the defined period, compared to 39 historical non-COVID controls. The overall incidence of barotrauma in COVID-19 patients was 37/165 (22.4%) compared to 4/39 (10.3%) in the control group. Patients with COVID-19 and barotrauma had a significantly worse survival (HR = 1.56, p = 0.047) compared to controls. In those requiring invasive mechanical ventilation, the COVID group also had significantly higher rates of barotrauma (OR 3.1, p = 0.03) and worse all-cause mortality (OR 2.21, p = 0.018). COVID-19 with barotrauma had significantly higher LOS in the ICU and the hospital. <h4>Conclusions</h4> Our data on critically ill COVID-19 patients admitted to the ICU shows a high incidence of barotrauma and mortality compared to the controls. Additionally, we report a high incidence of barotrauma even in non-ventilated ICU patients.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9997869/?tool=EBI |
| spellingShingle | Sunil Sharma Varun Badami Edward Rojas Rahul Sangani Kyle Chapman Carlo Avalon Austin King Sijin Wen High incidence of barotrauma in patients admitted with COVID-19 to ICU and associated mortality in rural Appalachia: An observational study PLoS ONE |
| title | High incidence of barotrauma in patients admitted with COVID-19 to ICU and associated mortality in rural Appalachia: An observational study |
| title_full | High incidence of barotrauma in patients admitted with COVID-19 to ICU and associated mortality in rural Appalachia: An observational study |
| title_fullStr | High incidence of barotrauma in patients admitted with COVID-19 to ICU and associated mortality in rural Appalachia: An observational study |
| title_full_unstemmed | High incidence of barotrauma in patients admitted with COVID-19 to ICU and associated mortality in rural Appalachia: An observational study |
| title_short | High incidence of barotrauma in patients admitted with COVID-19 to ICU and associated mortality in rural Appalachia: An observational study |
| title_sort | high incidence of barotrauma in patients admitted with covid 19 to icu and associated mortality in rural appalachia an observational study |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9997869/?tool=EBI |
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