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Improving survival of critical care patients With coronavirus disease 2019 in England : a national cohort study, March to June 2020
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Dennis, John M., McGovern, Andrew P., Vollmer, Sebastian J. and Mateen, Bilal A. (2021) Improving survival of critical care patients With coronavirus disease 2019 in England : a national cohort study, March to June 2020. Critical Care Medicine, 49 (2). pp. 209-214. doi:10.1097/CCM.0000000000004747 ISSN 0090-3493.
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Official URL: http://dx.doi.org/10.1097/CCM.0000000000004747
Abstract
Objectives:
To measure temporal trends in survival over time in people with severe coronavirus disease 2019 requiring critical care (high dependency unit or ICU) management, and to assess whether temporal variation in mortality was explained by changes in patient demographics and comorbidity burden over time.
Design:
Retrospective observational cohort; based on data reported to the COVID-19 Hospitalisation in England Surveillance System. The primary outcome was in-hospital 30-day all-cause mortality. Unadjusted survival was estimated by calendar week of admission, and Cox proportional hazards models were used to estimate adjusted survival, controlling for age, sex, ethnicity, major comorbidities, and geographical region.
Setting:
One hundred eight English critical care units.
Patients:
All adult (18 yr +) coronavirus disease 2019 specific critical care admissions between March 1, 2020, and June 27, 2020.
Interventions:
Not applicable.
Measurements and Main Results:
Twenty-one thousand eighty-two critical care patients (high dependency unit n = 15,367; ICU n = 5,715) were included. Unadjusted survival at 30 days was lowest for people admitted in late March in both high dependency unit (71.6% survival) and ICU (58.0% survival). By the end of June, survival had improved to 92.7% in high dependency unit and 80.4% in ICU. Improvements in survival remained after adjustment for patient characteristics (age, sex, ethnicity, and major comorbidities) and geographical region.
Conclusions:
There has been a substantial improvement in survival amongst people admitted to critical care with coronavirus disease 2019 in England, with markedly higher survival rates in people admitted in May and June compared with those admitted in March and April. Our analysis suggests this improvement is not due to temporal changes in the age, sex, ethnicity, or major comorbidity burden of admitted patients.
| Item Type: | Journal Article | ||||||||||||||||||||||||||||||
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| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Science, Engineering and Medicine > Science > Mathematics | ||||||||||||||||||||||||||||||
| Library of Congress Subject Headings (LCSH): | COVID-19 (Disease) , COVID-19 (Disease) -- Epidemiology -- Mathematical models , COVID-19 (Disease) -- Patients -- Treatment , COVID-19 (Disease) -- Patients -- Mathematical models , COVID-19 (Disease) -- Treatment -- Mathematical models , Intensive care units, Critically ill -- Treatment -- Mathematical models , Coronavirus infections , Critical care medicine, Medical care -- Quality control | ||||||||||||||||||||||||||||||
| Journal or Publication Title: | Critical Care Medicine | ||||||||||||||||||||||||||||||
| Publisher: | Lippincott Williams & Wilkins | ||||||||||||||||||||||||||||||
| ISSN: | 0090-3493 | ||||||||||||||||||||||||||||||
| Official Date: | February 2021 | ||||||||||||||||||||||||||||||
| Dates: |
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| Volume: | 49 | ||||||||||||||||||||||||||||||
| Number: | 2 | ||||||||||||||||||||||||||||||
| Page Range: | pp. 209-214 | ||||||||||||||||||||||||||||||
| DOI: | 10.1097/CCM.0000000000004747 | ||||||||||||||||||||||||||||||
| Status: | Peer Reviewed | ||||||||||||||||||||||||||||||
| Publication Status: | Published | ||||||||||||||||||||||||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||||||||||||||||||||||||
| Date of first compliant deposit: | 10 August 2021 | ||||||||||||||||||||||||||||||
| Date of first compliant Open Access: | 11 August 2021 | ||||||||||||||||||||||||||||||
| RIOXX Funder/Project Grant: |
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| Is Part Of: | 1 |
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