| Title: |
Hospital Mortality and Resource Implications of Hospitalisation with COVID-19 in London, UK: A Prospective Cohort Study |
| Authors: |
Vlachos, Savvas; Wong, Adrian; Metaxa, Victoria; Canestrini, Sergio; Lopez Soto, Carmen; Periselneris, Jimstan; Lee, Kai; Patrick, Tanya; Stovin, Christopher; Abernethy, Katrina; Albudoor, Budoor; Banerjee, Rishi; Juma, Fatimah; Al-Hashimi, Sara; Bernal, William; maharaj, ritesh |
| Source: |
Critical care research and practice, 2021:8832660 |
| Publication Year: |
2021 |
| Collection: |
Publisso (ZB MED-Publikationsportal Lebenswissenschaften) |
| Subject Terms: |
COVID-19 |
| Description: |
BACKGROUND: Coronavirus disease 2019 (COVID-19) had a significant impact on the National Health Service in the United Kingdom (UK), with over 35 000 cases reported in London by July 30, 2020. Detailed hospital-level information on patient characteristics, outcomes, and capacity strain is currently scarce but would guide clinical decision-making and inform prioritisation and planning. METHODS: We aimed to determine factors associated with hospital mortality and describe hospital and ICU strain by conducting a prospective cohort study at a tertiary academic centre in London, UK. We included adult patients admitted to the hospital with laboratory-confirmed COVID-19 and followed them up until hospital discharge or 30 days. Baseline factors that are associated with hospital mortality were identified via semiparametric and parametric survival analyses. RESULTS: Our study included 429 patients: 18% of them were admitted to the ICU, 52% met criteria for ICU outreach team activation, and 61% had treatment limitations placed during their admission. Hospital mortality was 26% and ICU mortality was 34%. Hospital mortality was independently associated with increasing age, male sex, history of chronic kidney disease, increasing baseline C-reactive protein level, and dyspnoea at presentation. COVID-19 resulted in substantial ICU and hospital strain, with up to 9 daily ICU admissions and 41 daily hospital admissions, to a peak census of 80 infected patients admitted in the ICU and 250 in the hospital. Management of such a surge required extensive reorganisation of critical care services with expansion of ICU capacity from 69 to 129 beds, redeployment of staff from other hospital areas, and coordinated hospital-level effort. CONCLUSIONS: COVID-19 is associated with a high burden of mortality for patients treated on the ward and the ICU and required substantial reconfiguration of critical care services. This has significant implications for planning and resource utilisation. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://repository.publisso.de/resource/frl:6425496; https://doi.org/10.1155/2021/8832660 |
| DOI: |
10.1155/2021/8832660 |
| Availability: |
https://repository.publisso.de/resource/frl:6425496; https://doi.org/10.1155/2021/8832660; https://www.hindawi.com/journals/ccrp/2021/8832660/#supplementary-materials |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.C977F013 |
| Database: |
BASE |