Shahla Siddiqui, MD, MS, D.ABA,FCCM
Attending Physician
Beth Israel Deaconess Medical Center
Boston, Massachusetts
Disclosure information not submitted.
Lauren Kelly, MPH
Biostatistician I
Beth Israel Deaconess Medical Center
Disclosure information not submitted.
Valerie Banner-Goodspeed, MPH
Clinical Research Administrator
Beth Israel Deaconess Medical Center, United States
Disclosure information not submitted.
Title: Discharge Outcomes of Patients With COVID 19 Admitted to the ICU: The International VIRUS Registry
Introduction: describe the discharge outcomes of patients admitted to the ICU in a multicentre, international coronavirus disease 2019 registry.
Methods: Cross-sectional observational study including coronavirus disease 2019 patients admitted to the ICU with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 infection between February 15, 2020, and June 30, 2021, looking at discharge disposition according to disease severity, age, race, gender and region.
Results: Primary outcome was discharge status. Secondary outcomes were discharge home with or without assistance disease severity, depth of sedation, mechanical ventilation, age, race, gender, region and yearly quarter of admission. Risk-adjusted variation in discharge disposition for patients receiving deep sedation (RASS >= -3) ventilation was assessed by using multilevel models with hospital admission source as a random effect, adjusted for age, race/ethnicity, sex, and maximum SOFA scores. Among 36,136 patients with coronavirus disease 2019, 12,779 were admitted to the ICU, and of these 10,820 met the inclusion criteria. The mean (± sd) age was 61.2 (±16), 6719 (62%) were men, and 3,719 (34.4%) died in the hospital.Of the 1670 patients who received sedation, 672 (40.2%) were deeply sedated (RASS >-3) at any point during their ICU stay, and of 2470 patients in which data was present 1181 (47.8%) received NMBAs. Factors that deterred non-assisted home discharge after ICU admission was significantly affected by deep sedation (RASS > -3) 498 (49.5%) vs 170 (26.2%) (p < 0.0001), age (mean age of home discharge patients was 54.8 (16%) vs 66.8 (14%) (p < .0.0001), receiving NMBA 879 (52.8%) vs 302 (37.5%) (p < 0.0001), receiving mechanical ventilation (median 10.4 (IQR 5 and 20) vs 8 (IQR 4 and 14) (p < 0.0001), Jan – March 2020 quarter (186 (6.8%) home discharge vs 228 (8.2%) non home discharge) (p < 0.0001), being African American (893 (17.8% home discharge vs 1230 (21.3%) non home discharge) (p < 0.0001), median SOFA scores (3 (IQR 1, 5.5) vs 6 (3.5, 8) (p < . 0001), admitted from another non nursing home facility (449 (8.9%) vs 896 (15.5%) (p < . 0001).
Conclusion: Deep sedation adversely affected discharge outcomes of Coronavirus disease 2019 patients who were admitted to the ICU.