Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, 2-124E Clinical Sciences Building, 8440-112 St NW, Edmonton, AB, T6G 2B7, Canada.
Critical Care Strategic Clinical Network, Alberta Health Services, Edmonton, AB, Canada.
Can J Anaesth. 2022 Nov;69(11):1399-1404. doi: 10.1007/s12630-022-02299-w. Epub 2022 Jul 26.
SARS-CoV-2 vaccines have been proven effective at preventing poor outcomes from COVID-19; however, voluntary vaccination rates have been suboptimal. We assessed the potential avoidable intensive care unit (ICU) resource use and associated costs had unvaccinated or partially vaccinated patients hospitalized with COVID-19 been fully vaccinated.
We conducted a retrospective, population-based cohort study of persons aged 12 yr or greater in Alberta (2021 population ~ 4.4 million) admitted to any ICU with COVID-19 from 6 September 2021 to 4 January 2022. We used publicly available aggregate data on COVID-19 infections, vaccination status, and health services use. Intensive care unit admissions, bed-days, lengths of stay, and costs were estimated for patients with COVID-19 and stratified by vaccination status.
In total, 1,053 patients admitted to the ICU with COVID-19 were unvaccinated, 42 were partially vaccinated, and 173 were fully vaccinated (cumulative incidence 230.6, 30.8, and 5.5 patients/100,000 population, respectively). Cumulative incidence rate ratios of ICU admission were 42.2 (95% confidence interval [CI], 39.7 to 44.9) for unvaccinated patients and 5.6 (95% CI, 4.1 to 7.6) for partially vaccinated patients when compared with fully vaccinated patients. During the study period, 1,028 avoidable ICU admissions and 13,015 bed-days were recorded for unvaccinated patients and the total avoidable costs were CAD 61.3 million. The largest opportunity to avoid ICU bed-days and costs was in unvaccinated patients aged 50 to 69 yr.
Unvaccinated patients with COVID-19 had substantially greater rates of ICU admissions, ICU bed-days, and ICU-related costs than vaccinated patients did. This increased resource use would have been potentially avoidable had these unvaccinated patients been vaccinated against SARS-CoV-2.
SARS-CoV-2 疫苗已被证明能有效预防 COVID-19 不良结局；然而，自愿接种率并不理想。我们评估了如果未接种或部分接种 COVID-19 疫苗的住院患者完全接种疫苗，潜在可避免的重症监护病房（ICU）资源使用和相关成本。
我们对 2021 年阿尔伯塔省（人口约 440 万）年龄在 12 岁及以上的人群进行了一项回顾性、基于人群的队列研究，这些人在 2021 年 9 月 6 日至 2022 年 1 月 4 日期间因 COVID-19 入住任何 ICU。我们使用了 COVID-19 感染、疫苗接种状态和卫生服务使用的公开可用的综合数据。根据疫苗接种状态对 COVID-19 患者的 ICU 入院、床位天数、住院时间和费用进行了估计。
共有 1053 名因 COVID-19 入住 ICU 的患者未接种疫苗，42 名部分接种疫苗，173 名完全接种疫苗（累积发病率分别为 230.6、30.8 和 5.5 例/10 万人）。与完全接种疫苗的患者相比，未接种疫苗的患者 ICU 入院的累积发病率比为 42.2（95%置信区间[CI]，39.7 至 44.9），部分接种疫苗的患者为 5.6（95% CI，4.1 至 7.6）。在研究期间，记录了 1028 例可避免的 ICU 入院和 13015 个床位天，这些是未接种疫苗患者的记录，总可避免费用为 6130 万加元。最大的避免 ICU 床位天数和成本的机会是在 50 至 69 岁的未接种疫苗患者中。
与接种疫苗的患者相比，COVID-19 未接种疫苗的患者 ICU 入院率、ICU 床位天数和与 ICU 相关的费用要高得多。如果这些未接种疫苗的患者接种了 SARS-CoV-2 疫苗，这些额外的资源使用本来是可以避免的。
