Center for Applied Health Research, Baylor Scott & White Research Institute, Dallas, Texas.
School of Nursing, University of Texas at Austin, Austin, Texas.
Respir Care. 2023 Apr;68(4):497-504. doi: 10.4187/respcare.10401. Epub 2022 Oct 11.
Many COVID-19 studies are constructed to report hospitalization outcomes, with few large multi-center population-based reports on the time course of intra-hospitalization characteristics, including daily oxygenation support requirements. Comprehensive epidemiologic profiles of oxygenation methods used by day and by week during hospitalization across all severities are important to illustrate the clinical and economic burden of COVID-19 hospitalizations.
This was a retrospective, multi-center observational cohort study of 15,361 consecutive hospitalizations of patients with COVID-19 at 25 adult acute care hospitals in Texas participating in the Society of Critical Care Medicine Discovery Viral Respiratory Illness Universal Study COVID-19 registry.
At initial hospitalization, the majority required nasal cannula (44.0%), with an increasing proportion of invasive mechanical ventilation in the first week and particularly the weeks to follow. After 4 weeks of acute illness, 69.9% of adults hospitalized with COVID-19 required intermediate (eg, high-flow nasal cannula, noninvasive ventilation) or advanced respiratory support (ie, invasive mechanical ventilation), with similar proportions that extended to hospitalizations that lasted ≥ 6 weeks.
Data representation of intra-hospital processes of care drawn from hospitals with varied size, teaching and trauma designations is important to presenting a balanced perspective of care delivery mechanisms employed, such as daily oxygen method utilization.
许多 COVID-19 研究旨在报告住院治疗结果，很少有大型多中心基于人群的报告涉及住院期间的特征，包括日常氧疗支持需求。全面描述各严重程度患者在住院期间每天和每周使用的氧疗方法的流行病学特征，对于说明 COVID-19 住院治疗的临床和经济负担非常重要。
这是一项在德克萨斯州 25 家成人急性护理医院参与重症监护医学学会发现病毒性呼吸道疾病普遍研究 COVID-19 登记处的 15361 例连续 COVID-19 住院患者的回顾性多中心观察队列研究。
在初始住院时，大多数患者需要鼻导管（44.0%），在第一周和随后的几周内，越来越多的患者需要使用有创机械通气。在急性发病的 4 周后，69.9%的 COVID-19 住院成人需要使用中级（例如高流量鼻导管、无创通气）或高级呼吸支持（即有创机械通气），有类似比例的患者需要延长至住院时间≥6 周。
从具有不同规模、教学和创伤指定的医院中获取的住院期间治疗过程数据对于展示所使用的治疗机制（例如每日氧疗方法的使用）的平衡视角非常重要。
