Johnston Craig, Subramaniam Ashwin, Orosz Judit, Burrell Aidan, Neto Ary Serpa, Young Meredith, Bailey Michael, Pilcher David, Udy Andrew, Jones Daryl
Department of Intensive Care and Hyperbaric Medicine, Alfred Hospital, Melbourne, VIC, Australia.
Intensive Care Unit, Frankston Hospital, Melbourne, VIC, Australia.
Crit Care Resusc. 2023 Oct 19;24(2):106-115. doi: 10.51893/2022.2.OA1. eCollection 2022 Jun 6.
: To evaluate the epidemiology of rapid response team (RRT) reviews that led to intensive care unit (ICU) admissions, and to evaluate the frequency of in-hospital cardiac arrests (IHCAs) among ICU patients with confirmed coronavirus disease 2019 (COVID-19) in Australia : Multicentre, retrospective cohort study. 48 public and private ICUs in Australia. All adults (aged ≥ 16 years) with confirmed COVID-19 admitted to participating ICUs between 25 January and 31 October 2020, as part of SPRINT-SARI (Short PeRiod IncideNce sTudy of Severe Acute Respiratory Infection) Australia, which were linked with ICUs contributing to the Australian and New Zealand Intensive Care Society Adult Patient Database (ANZICS APD). Of the 413 critically ill patients with COVID-19 who were analysed, 48.2% (199/413) were admitted from the ward and 30.5% (126/413) were admitted to the ICU following an RRT review. Patients admitted following an RRT review had higher Acute Physiology and Chronic Health Evaluation (APACHE) scores, fewer days from symptom onset to hospitalisation (median, 5.4 [interquartile range (IQR), 3.2-7.6] 7.1 days [IQR, 4.1-9.8]; < 0.001) and longer hospitalisations (median, 18 [IQR, 11-33] 13 days [IQR, 7-24]; < 0.001) compared with those not admitted via an RRT review. Admissions following RRT review comprised 60.3% (120/199) of all ward-based admissions. Overall, IHCA occurred in 1.9% (8/413) of ICU patients with COVID-19, and most IHCAs (6/8, 75%) occurred during ICU admission. There were no differences in IHCA rates or in ICU or hospital mortality rates based on whether a patient had a prior RRT review or not. : This study found that RRT reviews were a common way for deteriorating ward patients with COVID-19 to be admitted to the ICU, and that IHCA was rare among ICU patients with COVID-19.
评估导致重症监护病房（ICU）收治的快速反应小组（RRT）评估的流行病学情况，并评估澳大利亚确诊2019冠状病毒病（COVID-19）的ICU患者中院内心脏骤停（IHCA）的发生频率：多中心回顾性队列研究。澳大利亚48家公立和私立ICU。作为澳大利亚SPRINT-SARI（严重急性呼吸道感染短期发病率研究）的一部分，2020年1月25日至10月31日期间，所有确诊COVID-19并入住参与研究ICU的成年人（年龄≥16岁），这些数据与为澳大利亚和新西兰重症监护学会成人患者数据库（ANZICS APD）提供数据的ICU相关联。在分析的413例COVID-19重症患者中，48.2%（199/413）从病房收治，30.5%（126/413）在RRT评估后入住ICU。与未通过RRT评估收治的患者相比，RRT评估后收治的患者急性生理与慢性健康状况评估（APACHE）评分更高，症状出现到住院的天数更少（中位数为5.4天[四分位间距（IQR），3.2 - 7.6天]对7.1天[IQR，4.1 - 9.8天]；P < 0.001），住院时间更长（中位数为18天[IQR，11 - 33天]对13天[IQR，7 - 24天]；P < 0.001）。RRT评估后的收治病例占所有病房收治病例的60.3%（120/199）。总体而言，COVID-19的ICU患者中1.9%（8/413）发生了IHCA，大多数IHCA（6/8，75%）发生在ICU住院期间。根据患者是否接受过RRT评估，IHCA发生率、ICU或医院死亡率没有差异。：本研究发现，RRT评估是COVID-19病情恶化的病房患者入住ICU的常见方式，且COVID-19的ICU患者中IHCA很少见。
