Medium-term impacts of the waves of the COVID-19 epidemic on treatments for non-COVID-19 patients in intensive care units: A retrospective cohort study in Japan.
<h4>Background</h4>Maintaining critical care for non-Coronavirus-disease-2019 (non-COVID-19) patients is a key pillar of tackling the impact of the COVID-19 pandemic. This study aimed to reveal the medium-term impacts of the COVID-19 epidemic on case volumes and quality of intensive care...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0273952 |
| _version_ | 1811180763964506112 |
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| author | Shusuke Watanabe Jung-Ho Shin Takuya Okuno Tetsuji Morishita Daisuke Takada Susumu Kunisawa Yuichi Imanaka |
| author_facet | Shusuke Watanabe Jung-Ho Shin Takuya Okuno Tetsuji Morishita Daisuke Takada Susumu Kunisawa Yuichi Imanaka |
| author_sort | Shusuke Watanabe |
| collection | DOAJ |
| description | <h4>Background</h4>Maintaining critical care for non-Coronavirus-disease-2019 (non-COVID-19) patients is a key pillar of tackling the impact of the COVID-19 pandemic. This study aimed to reveal the medium-term impacts of the COVID-19 epidemic on case volumes and quality of intensive care for critically ill non-COVID-19 patients.<h4>Methods</h4>Administrative data were used to investigate the trends in case volumes of admissions to intensive care units (ICUs) compared with the previous years. Standardized mortality ratios (SMRs) of non-COVID-19 ICU patients were calculated in each wave of the COVID-19 epidemic in Japan.<h4>Results</h4>The ratios of new ICU admissions of non-COVID-19 patients to those in the corresponding months before the epidemic: 21% in May 2020, 8% in August 2020, 9% in February 2021, and 14% in May 2021, approximately concurrent with the peaks in COVID-19 infections. The decrease was greatest for new ICU admissions of non-COVID patients receiving invasive mechanical ventilation (IMV) on the first day of ICU admission: 26%, 15%, 19%, and 19% in the first, second, third, and fourth waves, respectively. No statistically significant change in SMR was observed in any wave of the epidemic; SMRs were 0.990 (95% uncertainty interval (UI), 0.962-1.019), 0.979 (95% UI, 0.953-1.006), 0.996 (95% UI, 0.980-1.013), and 0.989 (95% UI, 0.964-1.014), in the first, second, third, and fourth waves of the epidemic, respectively.<h4>Conclusions</h4>Compared to the previous years, the number of non-COVID-19 ICU patients continuously decreased over the medium term during the COVID-19 epidemic. The decrease in case volumes was larger in non-COVID-19 ICU patients initially receiving IMV than those undergoing other initial treatments. The standardized in-hospital mortality of non-COVID-19 ICU patients did not change in any waves of the epidemic. |
| first_indexed | 2024-04-11T09:08:46Z |
| format | Article |
| id | doaj.art-de0505956cf24960ad3d262bb00588f6 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T09:08:46Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-de0505956cf24960ad3d262bb00588f62022-12-22T04:32:34ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01179e027395210.1371/journal.pone.0273952Medium-term impacts of the waves of the COVID-19 epidemic on treatments for non-COVID-19 patients in intensive care units: A retrospective cohort study in Japan.Shusuke WatanabeJung-Ho ShinTakuya OkunoTetsuji MorishitaDaisuke TakadaSusumu KunisawaYuichi Imanaka<h4>Background</h4>Maintaining critical care for non-Coronavirus-disease-2019 (non-COVID-19) patients is a key pillar of tackling the impact of the COVID-19 pandemic. This study aimed to reveal the medium-term impacts of the COVID-19 epidemic on case volumes and quality of intensive care for critically ill non-COVID-19 patients.<h4>Methods</h4>Administrative data were used to investigate the trends in case volumes of admissions to intensive care units (ICUs) compared with the previous years. Standardized mortality ratios (SMRs) of non-COVID-19 ICU patients were calculated in each wave of the COVID-19 epidemic in Japan.<h4>Results</h4>The ratios of new ICU admissions of non-COVID-19 patients to those in the corresponding months before the epidemic: 21% in May 2020, 8% in August 2020, 9% in February 2021, and 14% in May 2021, approximately concurrent with the peaks in COVID-19 infections. The decrease was greatest for new ICU admissions of non-COVID patients receiving invasive mechanical ventilation (IMV) on the first day of ICU admission: 26%, 15%, 19%, and 19% in the first, second, third, and fourth waves, respectively. No statistically significant change in SMR was observed in any wave of the epidemic; SMRs were 0.990 (95% uncertainty interval (UI), 0.962-1.019), 0.979 (95% UI, 0.953-1.006), 0.996 (95% UI, 0.980-1.013), and 0.989 (95% UI, 0.964-1.014), in the first, second, third, and fourth waves of the epidemic, respectively.<h4>Conclusions</h4>Compared to the previous years, the number of non-COVID-19 ICU patients continuously decreased over the medium term during the COVID-19 epidemic. The decrease in case volumes was larger in non-COVID-19 ICU patients initially receiving IMV than those undergoing other initial treatments. The standardized in-hospital mortality of non-COVID-19 ICU patients did not change in any waves of the epidemic.https://doi.org/10.1371/journal.pone.0273952 |
| spellingShingle | Shusuke Watanabe Jung-Ho Shin Takuya Okuno Tetsuji Morishita Daisuke Takada Susumu Kunisawa Yuichi Imanaka Medium-term impacts of the waves of the COVID-19 epidemic on treatments for non-COVID-19 patients in intensive care units: A retrospective cohort study in Japan. PLoS ONE |
| title | Medium-term impacts of the waves of the COVID-19 epidemic on treatments for non-COVID-19 patients in intensive care units: A retrospective cohort study in Japan. |
| title_full | Medium-term impacts of the waves of the COVID-19 epidemic on treatments for non-COVID-19 patients in intensive care units: A retrospective cohort study in Japan. |
| title_fullStr | Medium-term impacts of the waves of the COVID-19 epidemic on treatments for non-COVID-19 patients in intensive care units: A retrospective cohort study in Japan. |
| title_full_unstemmed | Medium-term impacts of the waves of the COVID-19 epidemic on treatments for non-COVID-19 patients in intensive care units: A retrospective cohort study in Japan. |
| title_short | Medium-term impacts of the waves of the COVID-19 epidemic on treatments for non-COVID-19 patients in intensive care units: A retrospective cohort study in Japan. |
| title_sort | medium term impacts of the waves of the covid 19 epidemic on treatments for non covid 19 patients in intensive care units a retrospective cohort study in japan |
| url | https://doi.org/10.1371/journal.pone.0273952 |
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