Factors related to ICU transfer among patients with COVID-19 infections hospitalized in intermediate ICU: the study of phase 3 pandemic
DOI:
https://doi.org/10.14456/dcj.2024.17Keywords:
COVID-19 patients, treatment in intensive care unit (ICU), related factorsAbstract
In the situation of the COVID-19 outbreak, there are many factors that related with patients need to be transferred to the intensive care unit (ICU). This study was conducted among 439 COVID-19 infected patients who had been admitted to an intermediate care unit in Ramathibodi Chakri Naruebodindra Hospital during the phase 3 pandemic. The inclusion criteria were inpatients who were diagnosed with COVID-19 infection. Fifteen patients were excluded from the study as they died while being hospitalized in the intermediate ICU. There were totally 424 patients. The study was conducted between May 1 and September 30, 2021. Data was analyzed using descriptive statistics, which includes frequency, percentage, and standard deviation. The factors associated with transfer to ICU were assessed using the multiple logistic regression and an adjusted OR (aOR) at a 95% confidence interval. The results indicated that the study population consists of 207 male patients (48.8%), with a mean age of 59.8 ±16.0 years (SD=16.05). Seventy-five patients (17.7%) were transferred to ICU, while 349 patients (82.3%) were not transferred to ICU. The factors associated with transfer to ICU were awake prone position (aOR, 1.88; 95% CI; 1.01-3.51) and used the fraction of inspired oxygen (FiO2) above 0.6 (aOR, 8.32; 95% CI; 4.36-15.86). Findings from this study could be used as supporting information to determine ways to reduce the rate of unplanned ICU admissions and for the purposes of monitoring in high-risk patients to ensure more effective and high quality patient care.
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References
World Health Organization and the United Nations Development Programme. Uniatf policy-brief NCDs and COVID final [Internet]. 2020 [cited 2022 Jan 21]. Available from: https://cdn.who.int/media/docs/default-source/thailand/ncds/uniatf_policy-brief_ncds-and-covid_final_th.pdf?sfvrsn=5c166f07_3.
Berlin DA, Gulick RM, Martinez FJ. Severe COVID-19. N Engl J Med 2020;383(2):2451-60.
Department of Disease Control (TH). Emergency operations center, Department of disease control. Thailand weekly situation update on 26 September 2021 [Internet]. 2021 [cited 2022 Aug 26]. Available from: https://ddc.moph.go.th/viralpneumonia/file/situation/situation- no631-250964.pdf (in Thai)
Centers for Disease Control and Prevention. Interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19) [Internet]. 2020 [cited 2021 Jan 10]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management -patients.html
Manmana S, Iamsirithaworn S, Uttayamakul S. Coronavirus Disease-19 (COVID-19). Bamrasnaradura Infect Dis Inst 2020;14(2):1-10. (in Thai)
Ungchusak K. Overview of field epidemiology [Internet]. 2019 [cited 2022 Jan 21]. http://www.interfetpthailand.net/th/file/June2019/pdf/wk1_Dr_kumnuan_17June.pdf.
Thanakijtummakul N. Nursing care for COVID-19 patients with acute respiratory distress syndrome. JTNMC 2021;36(3);16-30.
Naorungroj T, Viarasilpa T, Tongyoo S, Detkaew A, Pinpak T, Wimolwattanaphan R, et al. Characteristics, outcomes, and risk factors for in-hospital mortality of COVID-19 patients: A retrospective study in Thailand. Front Med 2022;9:1061955:1-11.
Du W, Yu J, Wang H, Zhang X, Zhang S, Li Q, et al. Clinical characteristics of COVID 19 in children compared with adults in Shandong Province, China. Infection 2020;48:445-52.
Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatrica 2020;109:1088-95.
Suwalapha C, Yongprawat T, Charoengid W, Laongam P. Experience in the Cohort intermediate care unit arrangement and nursing management of patients with COVID-19 at Bangkok Hospital Headquarters. BKKMEDJ 2021;17(2):161-9.
Suarez-Cuartin G, Gasa M, Bermudo G, Ruiz Y, Hernandez-Argudo M, Marin A, et al. Clinical outcomes of severe COVID-19 patients admitted to an intermediate respiratory care unit. Front Med 2021;8(711027):1-10.
Gasa M, Ruiz-Albert Y, Cordoba-Izquierdo A, Sarasate M, Cuevas E, Suarez-Cuartin G, et al. Outcomes of COVID-19 patients admitted to the intermediate respiratory care unit: Non-invasive respiratory therapy in a sequential protocol. Int J Environ Res Public Health 2022;19(17):1-19.
Accordino S, Canetta C, Bettini G, Corsico F, Ghigliazza G, Barbetta L, et al. Clinical characteristics and outcomes of patients with acute respiratory failure due to SARS-CoV-2 interstitial pneumonia treated with CPAP in a medical intermediate care setting: A retrospective observational study on comparison of four waves. J Clin Med 2023;12(4):1-11.
Matute‑Villacis M, Moises J, Embid C, Armas J, Fernandez I, Medina M, et al. Role of respiratory intermediate care units during the SARS‑CoV-2 pandemic. BMC Pulm Med 2021;21(228):1-7.
Wu Z, McGoogan JM. Characteristics of and important lessons from the Coronavirus Disease 2019 (COVID-19) outbreak in China: Summary of a report of 72,314 cases from the Chinese center for disease control and prevention. JAMA 2020;323(13):1239-42.
Bhaskaran K, Rentsch CT, MacKenna B, Schultze A, Mehrkar A, Bates CJ, et al. HIV infection and COVID-19 death: a population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform. Lancet HIV 2021;8:e24-32.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet 2020;395(10229):1054-62.
Pandit RA, Gagana BN, Vaity C, Mulakavalupil B, Choudhary JS, Jain V, et al. Clinical characteristics and outcomes of COVID-19 patients hospitalized in intensive care unit. Indian J Crit Care Med 2021;25(9):992-1000.
Deng G, Yin M, Chen X, Zeng F. Clinical determinants for fatality of 44,672 patients with COVID-19. Critical care 2020;24(179):1-3.
Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, et al. OpenSAFELY: Factors associated with COVID-19-related death using Nature 2020;584(7821):430-6.
Lavin W, Yooyadmak P, Phenglai C. Risk of mortality among COVID-19 patients admitted to intermediate ICU: A study during the third wave of COVID-19 pandemic. Dis Control J 2023;49(1):11-20.
Adams JY, Rogers AJ, Schuler A, Marelich GP, Fresco JM, Taylor SL, et al. Association between peripheral blood oxygen saturation (SpO2)/ Fraction of inspired oxygen (FiO2) ratio time at risk and hospital mortality in mechanically ventilated patients. Perm J 2020;24(19.113):1-7.
Papazian L, Aubron C, Brochard L, Chiche JD, Combes A, Dreyfuss D, et al. Formal guidelines: management of acute respiratory distress syndrome. Ann Intensive Care 2019;9(1):69.
Yoriya E. Critical care nursing to reduce complications from prone position in ARDS patients. TRC Nurs J 2020;13(2):62-73.
Rahmani F, Salmasi S, Rezaeifar P. Prone position effects in the treatment of COVID-19 patients. Caspian J Intern Med 2020;11(1):S580-2.
Claudia G, Daniel K, Sebastiana H, Anna C, Christoph AF, Beat M, et al. Characteristics, predictors and outcomes among 99 patients
hospitalised with COVID-19 in a tertiary care centre in Switzerland: an observational analysis. Swiss Med Wkly 2020;150:w20316:1-7.
Sabetian G, Azimi A, Kazemi A, Hoseini B, Asmarian N, Khaloo V, et al. Prediction of patients with COVID-19 requiring Intensive Care: A cross-sectional study based on machine-learning approach from Iran. Indian J Crit Care Med 2022;26(6):688-95.
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