Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
J Intensive Care Med. 2023 Nov;38(11):1078-1083. doi: 10.1177/08850666231183398. Epub 2023 Jun 26.
The objective of this study was to evaluate the risk of mortality or ECMO cannulation for patients with confirmed or suspected COVID-19 transferred from sending hospitals to receiving tertiary care centers as a function of the duration of time at the sending hospital.
To determine outcomes of critically ill patients with COVID-19 who were transferred to tertiary or quarternary care medical centers.
Retrospective cohort study of critical care transports of patients to one of seven consortium tertiary care centers from March 1, 2020, through September 4, 2020. Age 14 years and older with confirmed or suspected COVID-19 transported from a sending hospital to a receiving tertiary care center by the critical care transport organization.
Patients transported with confirmed or suspected COVID-19 to tertiary care centers had a mortality rate of 38.0%. Neither the number of days admitted, nor the number of days intubated at the sending hospital correlated with mortality (correlation coefficient 0.051 and -0.007, respectively). Similarly, neither the number of days admitted, nor number of days intubated at the sending hospital correlated with ECMO cannulation (correlation coefficient 0.008 and -0.036, respectively).
It may be reasonable to transfer a critically ill COVID-19 patient to a tertiary care center even if they have been admitted at the sending hospital for several days.
本研究旨在评估确诊或疑似 COVID-19 患者从转院医院转移到接收三级护理中心的死亡或 ECMO 置管风险与在转院医院的时间长短的关系。
确定转至三级或四级护理医疗中心的危重症 COVID-19 患者的结局。
这是一项回顾性队列研究,研究对象为 2020 年 3 月 1 日至 2020 年 9 月 4 日期间,通过重症监护转运组织从一家转院医院转运至七家联盟三级护理中心的患者。年龄 14 岁及以上,确诊或疑似 COVID-19,由重症监护转运组织从转院医院转运至接收的三级护理中心。
转运至三级护理中心的确诊或疑似 COVID-19 患者的死亡率为 38.0%。在发送医院的住院天数和插管天数均与死亡率无关(相关系数分别为 0.051 和-0.007)。同样,在发送医院的住院天数和插管天数均与 ECMO 置管无关(相关系数分别为 0.008 和-0.036)。
即使患者在转院医院住院数天,将危重症 COVID-19 患者转至三级护理中心可能也是合理的。