Literature DB >> 33786437

ICU Bed Utilization During the Coronavirus Disease 2019 Pandemic in a Multistate Analysis-March to June 2020.

David J Douin1, Michael J Ward2, Christopher J Lindsell2, Michelle P Howell1, Catherine L Hough3, Matthew C Exline4, Michelle N Gong5, Michael S Aboodi5, Mark W Tenforde6, Leora R Feldstein6, William B Stubblefield2, Jay S Steingrub7, Matthew E Prekker8, Samuel M Brown9, Ithan D Peltan9, Akram Khan3, D Clark Files10, Kevin W Gibbs10, Todd W Rice2, Jonathan D Casey2, David N Hager11, Nida Qadir12, Daniel J Henning13, Jennifer G Wilson14, Manish M Patel6, Wesley H Self2, Adit A Ginde1.   

Abstract

OBJECTIVES: Given finite ICU bed capacity, knowledge of ICU bed utilization during the coronavirus disease 2019 pandemic is critical to ensure future strategies for resource allocation and utilization. We sought to examine ICU census trends in relation to ICU bed capacity during the rapid increase in severe coronavirus disease 2019 cases early during the pandemic.
DESIGN: Observational cohort study.
SETTING: Thirteen geographically dispersed academic medical centers in the United States. PATIENTS/
SUBJECTS: We obtained daily ICU censuses from March 26 to June 30, 2020, as well as prepandemic ICU bed capacities. The primary outcome was daily census of ICU patients stratified by coronavirus disease 2019 and mechanical ventilation status in relation to ICU capacity.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Prepandemic overall ICU capacity ranged from 62 to 225 beds (median 109). During the study period, the median daily coronavirus disease 2019 ICU census per hospital ranged from 1 to 84 patients, and the daily ICU census exceeded overall ICU capacity for at least 1 day at five institutions. The number of critically ill patients exceeded ICU capacity for a median (interquartile range) of 17 (12-50) of 97 days at these five sites. All 13 institutions experienced decreases in their noncoronavirus disease ICU population, whereas local coronavirus disease 2019 cases increased. Coronavirus disease 2019 patients reached their greatest proportion of ICU capacity on April 12, 2020, when they accounted for 44% of ICU patients across all participating hospitals. Maximum ICU census ranged from 52% to 289% of overall ICU capacity, with three sites less than 80%, four sites 80-100%, five sites 100-128%, and one site 289%.
CONCLUSIONS: From March to June 2020, the coronavirus disease 2019 pandemic led to ICU censuses greater than ICU bed capacity at fives of 13 institutions evaluated. These findings demonstrate the short-term adaptability of U.S. healthcare institutions in redirecting limited resources to accommodate a public health emergency.
Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.

Entities:  

Keywords:  capacity; coronavirus disease 2019; intensive care unit; mechanical ventilation; resource allocation

Year:  2021        PMID: 33786437      PMCID: PMC7994039          DOI: 10.1097/CCE.0000000000000361

Source DB:  PubMed          Journal:  Crit Care Explor        ISSN: 2639-8028


  35 in total

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6.  The likely economic impact of fewer elective surgical procedures on US hospitals during the COVID-19 pandemic.

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Review 10.  Managing ICU surge during the COVID-19 crisis: rapid guidelines.

Authors:  Shadman Aziz; Yaseen M Arabi; Waleed Alhazzani; Laura Evans; Giuseppe Citerio; Katherine Fischkoff; Jorge Salluh; Geert Meyfroidt; Fayez Alshamsi; Simon Oczkowski; Elie Azoulay; Amy Price; Lisa Burry; Amy Dzierba; Andrew Benintende; Jill Morgan; Giacomo Grasselli; Andrew Rhodes; Morten H Møller; Larry Chu; Shelly Schwedhelm; John J Lowe; Du Bin; Michael D Christian
Journal:  Intensive Care Med       Date:  2020-06-08       Impact factor: 41.787

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  5 in total

1.  Modeling clinical trajectory status of critically ill COVID-19 patients over time: A method for analyzing discrete longitudinal and ordinal outcomes.

Authors:  Michael J Ward; David J Douin; Wu Gong; Adit A Ginde; Catherine L Hough; Matthew C Exline; Mark W Tenforde; William B Stubblefield; Jay S Steingrub; Matthew E Prekker; Akram Khan; D Clark Files; Kevin W Gibbs; Todd W Rice; Jonathan D Casey; Daniel J Henning; Jennifer G Wilson; Samuel M Brown; Manish M Patel; Wesley H Self; Christopher J Lindsell
Journal:  J Clin Transl Sci       Date:  2022-04-25

Review 2.  A systematic review of de-escalation strategies for redeployed staff and repurposed facilities in COVID-19 intensive care units (ICUs) during the pandemic.

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Journal:  EClinicalMedicine       Date:  2022-02-07

3.  Differences and Similarities Among COVID-19 Patients Treated in Seven ICUs in Three Countries Within One Region: An Observational Cohort Study.

Authors:  Dieter Mesotten; Daniek A M Meijs; Bas C T van Bussel; Björn Stessel; Jannet Mehagnoul-Schipper; Anisa Hana; Clarissa I E Scheeren; Ulrich Strauch; Marcel C G van de Poll; Chahinda Ghossein-Doha; Wolfgang F F A Buhre; Johannes Bickenbach; Margot Vander Laenen; Gernot Marx; Iwan C C van der Horst
Journal:  Crit Care Med       Date:  2022-04-01       Impact factor: 9.296

4.  A customized early warning score enhanced emergency department patient flow process and clinical outcomes in a COVID-19 pandemic.

Authors:  Ali Yazdanyar; Megan R Greenberg; Zhe Chen; Shuisen Li; Marna Rayl Greenberg; Anthony P Buonanno; David B Burmeister; Shadi Jarjous
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5.  Comparison of Use of Neoadjuvant Systemic Treatment for Breast Cancer and Short-term Outcomes Before vs During the COVID-19 Era in Ontario, Canada.

Authors:  Steven Habbous; Xiaochen Tai; Jaclyn M Beca; Jessica Arias; Michael J Raphael; Ambica Parmar; Andrea Crespo; Matthew C Cheung; Andrea Eisen; Antoine Eskander; Simron Singh; Maureen Trudeau; Scott Gavura; Wei Fang Dai; Jonathan Irish; Monika Krzyzanowska; Lauren Lapointe-Shaw; Rohini Naipaul; Stuart Peacock; Lyndee Yeung; Leta Forbes; Kelvin K W Chan
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