Imperial College London
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ProfessorSamirBhatt

Faculty of Medicine, School of Public Health

Professor of Statistics and Public Health
 
 
 
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Contact

 

+44 (0)20 7594 5029s.bhatt

 
 
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Location

 

G32ASt Mary's Research BuildingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Wilde:2021:10.1186/s12916-021-02096-0,
author = {Wilde, H and Mellan, T and Hawryluk, I and Dennis, JM and Denaxas, S and Pagel, C and Duncan, A and Bhatt, S and Flaxman, S and Mateen, BA and Vollmer, SJ},
doi = {10.1186/s12916-021-02096-0},
journal = {BMC Medicine},
pages = {1--12},
title = {The association between mechanical ventilator compatible bed occupancy and mortality risk in intensive care patients with COVID-19: a national retrospective cohort study.},
url = {http://dx.doi.org/10.1186/s12916-021-02096-0},
volume = {19},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: The literature paints a complex picture of the association between mortality risk and ICU strain. In this study, we sought to determine if there is an association between mortality risk in intensive care units (ICU) and occupancy of beds compatible with mechanical ventilation, as a proxy for strain. METHODS: A national retrospective observational cohort study of 89 English hospital trusts (i.e. groups of hospitals functioning as single operational units). Seven thousand one hundred thirty-three adults admitted to an ICU in England between 2 April and 1 December, 2020 (inclusive), with presumed or confirmed COVID-19, for whom data was submitted to the national surveillance programme and met study inclusion criteria. A Bayesian hierarchical approach was used to model the association between hospital trust level (mechanical ventilation compatible), bed occupancy, and in-hospital all-cause mortality. Results were adjusted for unit characteristics (pre-pandemic size), individual patient-level demographic characteristics (age, sex, ethnicity, deprivation index, time-to-ICU admission), and recorded chronic comorbidities (obesity, diabetes, respiratory disease, liver disease, heart disease, hypertension, immunosuppression, neurological disease, renal disease). RESULTS: One hundred thirty-five thousand six hundred patient days were observed, with a mortality rate of 19.4 per 1000 patient days. Adjusting for patient-level factors, mortality was higher for admissions during periods of high occupancy (> 85% occupancy versus the baseline of 45 to 85%) [OR 1.23 (95% posterior credible interval (PCI): 1.08 to 1.39)]. In contrast, mortality was decreased for admissions during periods of low occupancy (< 45% relative to the baseline) [OR 0.83 (95% PCI 0.75 to 0.94)]. CONCLUSION: Increasing occupancy of beds compatible with mechanical ventilation, a proxy for operational strain, is associated with a higher mortality risk for individuals admitted to ICU
AU  - Wilde,H
AU  - Mellan,T
AU  - Hawryluk,I
AU  - Dennis,JM
AU  - Denaxas,S
AU  - Pagel,C
AU  - Duncan,A
AU  - Bhatt,S
AU  - Flaxman,S
AU  - Mateen,BA
AU  - Vollmer,SJ
DO  - 10.1186/s12916-021-02096-0
EP  - 12
PY  - 2021///
SN  - 1741-7015
SP  - 1
TI  - The association between mechanical ventilator compatible bed occupancy and mortality risk in intensive care patients with COVID-19: a national retrospective cohort study.
T2  - BMC Medicine
UR  - http://dx.doi.org/10.1186/s12916-021-02096-0
UR  - https://www.ncbi.nlm.nih.gov/pubmed/34461893
UR  - https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-02096-0
UR  - http://hdl.handle.net/10044/1/91521
VL  - 19
ER  -
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