Department of Anaesthesiology, Division of Emergencies and Critical Care, Rikshospitalet Medical Centre, Oslo University Hospital, Oslo, Norway.
Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
Acta Anaesthesiol Scand. 2021 May;65(5):618-628. doi: 10.1111/aas.13785. Epub 2021 Feb 27.
Norwegian hospitals have operated within capacity during the COVID-19 pandemic. We present patient and management characteristics, and outcomes for the entire cohort of adult (>18 years) COVID-19 patients admitted to Norwegian intensive care units (ICU) from 10 March to 19 June 2020.
Data were collected from The Norwegian intensive care and pandemic registry (NIPaR). Demographics, co-morbidities, management characteristics and outcomes are described. ICU length of stay (LOS) was analysed with linear regression, and associations between risk factors and mortality were quantified using Cox regression.
In total, 217 patients were included. The male to female ratio was 3:1 and the median age was 63 years. A majority (70%) had one or more co-morbidities, most frequently cardiovascular disease (39%), chronic lung disease (22%), diabetes mellitus (20%), and obesity (17%). Most patients were admitted for acute hypoxaemic respiratory failure (AHRF) (91%) and invasive mechanical ventilation (MV) was used in 86%, prone ventilation in 38% and 25% of patients received a tracheostomy. Vasoactive drugs were used in 79% and renal replacement therapy in 15%. Median ICU LOS and time of MV was 14.0 and 12.0 days. At end of follow-up 45 patients (21%) were dead. Age, co-morbidities and severity of illness at admission were predictive of death. Severity of AHRF and male gender were associated with LOS.
In this national cohort of COVID-19 patients, mortality was low and attributable to known risk factors. Importantly, prolonged length-of-stay must be taken into account when planning for resource allocation for any next surge.
在 COVID-19 大流行期间,挪威医院的运转能力一直处于满负荷状态。我们展示了 2020 年 3 月 10 日至 6 月 19 日期间,所有成年(>18 岁)COVID-19 患者入住挪威重症监护病房(ICU)的患者和管理特征以及结局。
数据来自挪威重症监护和大流行登记处(NIPaR)。描述了人口统计学、合并症、管理特征和结局。使用线性回归分析 ICU 住院时间(LOS),并使用 Cox 回归量化危险因素与死亡率之间的关联。
共纳入 217 例患者。男女比例为 3:1,中位年龄为 63 岁。大多数患者(70%)患有一种或多种合并症,最常见的是心血管疾病(39%)、慢性肺部疾病(22%)、糖尿病(20%)和肥胖症(17%)。大多数患者因急性低氧性呼吸衰竭(AHRF)入院(91%),86%接受了有创机械通气(MV),38%接受了俯卧位通气,25%的患者接受了气管切开术。79%的患者使用了血管活性药物,15%的患者接受了肾脏替代治疗。ICU LOS 和 MV 时间的中位数分别为 14.0 和 12.0 天。随访结束时,45 名患者(21%)死亡。年龄、入院时的合并症和疾病严重程度是死亡的预测因素。AHRF 的严重程度和男性与 LOS 相关。
在本项 COVID-19 患者的全国性队列研究中,死亡率较低,且可归因于已知的危险因素。重要的是,在为任何下一次激增规划资源分配时,都必须考虑到较长的住院时间。