Out-of-hours intensive care unit admission and 90-day mortality: a Danish nationwide cohort study

2018 ◽  
Vol 62 (7) ◽  
pp. 974-982 ◽  
Author(s):  
D. L. Buck ◽  
C. F. Christiansen ◽  
S. Christensen ◽  
M. H. Møller ◽  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Out Of Hours

scholarly journals Coronavirus disease 2019 outcomes among patients with rheumatic diseases 6 months into the pandemic

2020 ◽  
pp. annrheumdis-2020-219279
Author(s):  
Naomi Serling-Boyd ◽  
Kristin M D’Silva ◽  
Tiffany YT Hsu ◽  
Rachel Wallwork ◽  
Xiaoqing Fu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Cohort Study ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Rheumatic Diseases ◽  
Cox Regression ◽  
Diagnosis Date ◽  
Recent Cohort ◽  
Over Time

ObjectiveIn earlier studies, patients with rheumatic and musculoskeletal disease (RMD) who got infected with COVID-19 had a higher risk of mechanical ventilation than comparators. We sought to determine COVID-19 outcomes among patients with RMD 6 months into the pandemic.MethodsWe conducted a cohort study at Mass General Brigham in Boston, Massachusetts, of patients with RMD matched to up to five comparators by age, sex and COVID-19 diagnosis date (between 30 January 2020 and 16 July 2020) and followed until last encounter or 18 August 2020. COVID-19 outcomes were compared using Cox regression. Risk of mechanical ventilation was compared in an early versus a recent cohort of patients with RMD.ResultsWe identified 143 patients with RMD and with COVID-19 (mean age 60 years; 76% female individuals) and 688 comparators (mean age 59 years; 76% female individuals). There were no significantly higher adjusted risks of hospitalisation (HR: 0.87, 95% CI: 0.68–1.11), intensive care unit admission (HR: 1.27, 95% CI: 0.86–1.86), or mortality (HR: 1.02, 95% CI: 0.53–1.95) in patients with RMD versus comparators. There was a trend towards a higher risk of mechanical ventilation in the RMD cohort versus comparators, although not statistically significant (adjusted HR: 1.51, 95% CI: 0.93–2.44). There was a trend towards improvement in mechanical ventilation risk in the recent versus early RMD cohort (10% vs 19%, adjusted HR: 0.44, 95% CI: 0.17–1.12).ConclusionsPatients with RMD and comparators had similar risks of poor COVID-19 outcomes after adjusting for race, smoking and comorbidities. The higher risk of mechanical ventilation in the early RMD cohort was no longer detected in a recent cohort, suggesting improved management over time.

scholarly journals RISK OF ADVERSE OUTCOMES IN HOSPITALIZED PATIENTS WITH AUTOIMMUNE DISEASE AND COVID-19: A MATCHED COHORT STUDY FROM NEW YORK CITY

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S44-S44
Author(s):  
Adam Faye ◽  
Kate Lee ◽  
Monika Laszkowska ◽  
Judith Kim ◽  
John Blackett ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
New York ◽  
Cohort Study ◽  
Intensive Care ◽  
Autoimmune Disease ◽  
Intensive Care Unit Admission ◽  
Hospitalized Patients ◽  
Secondary Outcome ◽  
Composite Outcome ◽  
Increased Risk

Abstract Objective To examine the impact of autoimmune disease on the composite outcome of intensive care unit admission, intubation, or death, from COVID-19 in hospitalized patients. Methods Retrospective cohort study of 186 patients hospitalized with COVID-19 between March 1st–April 15th, 2020 at New York-Presbyterian Hospital/Columbia University Irving Medical Center. The cohort included 62 patients with autoimmune disease and 124 age- and sex- matched controls. The primary outcome was a composite of intensive care unit admission, intubation, and death, with secondary outcome assessing time to in-hospital death. Baseline demographics, comorbidities, medications, vital signs, and laboratory values were collected. Conditional logistic regression and Cox proportional hazards regression were used to assess the association between autoimmune disease and clinical outcomes. Results Patients with autoimmune disease were more likely to have at least one comorbidity (25.8% vs. 12.9%, p=0.03), take chronic immunosuppressive medications (66.1% vs. 4.0%, p<0.01), and have had a solid organ transplant (16.1% vs. 1.6%, p<0.01). There were no significant differences in intensive care unit admission (14.2% vs. 19.4%, p=0.44), intubation (14.2% vs. 17.7%, p=0.62) or death (17.5% vs. 14.5%, p=0.77). On multivariable analysis, patients with autoimmune disease were not at an increased risk for a composite outcome of intensive care unit admission, intubation, or death (adjOR 0.79, 95%CI 0.37–1.67). On Cox regression, autoimmune disease was not associated with in-hospital mortality (adjHR 0.73, 95%CI 0.33–1.63). Conclusion Among patients hospitalized with COVID-19, individuals with autoimmune disease did not have an increased risk of a composite outcome of intensive care unit admission, intubation, or death. Kaplan-Meier curve examining death, stratified by the presence or absence of autoimmune disease in all 186 patients, with 16 patients censored as of 4/29/2020

Clinical significance of palliative care assessment in patients referred for urgent intensive care unit admission: A cohort study

2017 ◽  
Vol 37 ◽  
pp. 24-29
Author(s):  
Joao Gabriel Rosa Ramos ◽  
Mario Diego Teles Correa ◽  
Ricardo Tavares de Carvalho ◽  
Daryl Jones ◽  
Daniel Neves Forte
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Cohort Study ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Clinical Significance ◽  
Care Assessment
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