Evolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 months

Detalhes bibliográficos
Autor(a) principal: Kurtz, Pedro
Data de Publicação: 2021
Outros Autores: Bastos, Leonardo S. L., Dantas, Leila F., Zampieri, Fernando G., Soares, Marcio, Hamacher, Silvio, Salluh, Jorge I. F., Bozza, Fernando A.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/47288
Resumo: Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Hospital Copa Star. Rio de Janeiro, RJ, Brasil / Instituto Estadual do Cérebro Paulo Niemeyer. Rio de Janeiro, RJ, Brasil.
id CRUZ_b91f0e054b46fdd287e1696f60959c3b
oai_identifier_str oai:www.arca.fiocruz.br:icict/47288
network_acronym_str CRUZ
network_name_str Repositório Institucional da FIOCRUZ (ARCA)
repository_id_str 2135
spelling Kurtz, PedroBastos, Leonardo S. L.Dantas, Leila F.Zampieri, Fernando G.Soares, MarcioHamacher, SilvioSalluh, Jorge I. F.Bozza, Fernando A.2021-05-21T13:32:46Z2021-05-21T13:32:46Z2021KURTZ, Pedro et al. Evolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 months. Intensive care medicine, p. 1–11, 20210342-4642https://www.arca.fiocruz.br/handle/icict/4728810.1007/s00134-021-06388-0engSpringerEvolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 monthsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleInstituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Hospital Copa Star. Rio de Janeiro, RJ, Brasil / Instituto Estadual do Cérebro Paulo Niemeyer. Rio de Janeiro, RJ, Brasil.Pontifícia Universidade Católica do Rio de Janeiro. Departamento de Engenharia Industrial. Rio de Janeiro, RJ, Brasil.Pontifícia Universidade Católica do Rio de Janeiro. Departamento de Engenharia Industrial. Rio de Janeiro, RJ, Brasil.Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Hospital Do Coração. Instituto de Pesquisa. São Paulo, SP, Brasil / Southern Denmark University. Center for Epidemiological Research. Odense, Denmark.Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil.Pontifícia Universidade Católica do Rio de Janeiro. Departamento de Engenharia Industrial. Rio de Janeiro, RJ, Brasil.Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Programa de Pós-Graduação em Clínica Médica. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil.Purpose: Clinical characteristics and management of COVID-19 patients have evolved during the pandemic, potentially changing their outcomes. We analyzed the associations of changes in mortality rates with clinical profiles and respiratory support strategies in COVID-19 critically ill patients. Methods: A multicenter cohort of RT-PCR-confirmed COVID-19 patients admitted at 126 Brazilian intensive care units between February 27th and October 28th, 2020. Assessing temporal changes in deaths, we identified distinct time periods. We evaluated the association of characteristics and respiratory support strategies with 60-day in-hospital mortality using random-effects multivariable Cox regression with inverse probability weighting. Results: Among the 13,301 confirmed-COVID-19 patients, 60-day in-hospital mortality was 13%. Across four time periods identified, younger patients were progressively more common, non-invasive respiratory support was increasingly used, and the 60-day in-hospital mortality decreased in the last two periods. 4188 patients received advanced respiratory support (non-invasive or invasive), from which 42% underwent only invasive mechanical ventilation, 37% only non-invasive respiratory support and 21% failed non-invasive support and were intubated. After adjusting for organ dysfunction scores and premorbid conditions, we found that younger age, absence of frailty and the use of non-invasive respiratory support (NIRS) as first support strategy were independently associated with improved survival (hazard ratio for NIRS first [95% confidence interval], 0.59 [0.54-0.65], p < 0.001). Conclusion: Age and mortality rates have declined over the first 8 months of the pandemic. The use of NIRS as the first respiratory support measure was associated with survival, but causal inference is limited by the observational nature of our data.CoronavirusIn-hospital mortalityNon-invasive ventilationRespiratory supportinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83099https://www.arca.fiocruz.br/bitstream/icict/47288/1/license.txt586c046dcfeef936e32f0323bb9a47c0MD51ORIGINALEnvolving_Fernando_Bozza_etal_INI_2021.pdfEnvolving_Fernando_Bozza_etal_INI_2021.pdfapplication/pdf1551224https://www.arca.fiocruz.br/bitstream/icict/47288/2/Envolving_Fernando_Bozza_etal_INI_2021.pdfd7fe37abe6554191338055bfc738293fMD52TEXTEnvolving_Fernando_Bozza_etal_INI_2021.pdf.txtEnvolving_Fernando_Bozza_etal_INI_2021.pdf.txtExtracted texttext/plain44972https://www.arca.fiocruz.br/bitstream/icict/47288/3/Envolving_Fernando_Bozza_etal_INI_2021.pdf.txt45dcaaffe07ef76ce77712cbdea1b689MD53icict/472882021-05-22 02:06:44.96oai:www.arca.fiocruz.br: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ório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352021-05-22T05:06:44Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.pt_BR.fl_str_mv Evolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 months
title Evolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 months
spellingShingle Evolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 months
Kurtz, Pedro
Coronavirus
In-hospital mortality
Non-invasive ventilation
Respiratory support
title_short Evolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 months
title_full Evolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 months
title_fullStr Evolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 months
title_full_unstemmed Evolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 months
title_sort Evolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 months
author Kurtz, Pedro
author_facet Kurtz, Pedro
Bastos, Leonardo S. L.
Dantas, Leila F.
Zampieri, Fernando G.
Soares, Marcio
Hamacher, Silvio
Salluh, Jorge I. F.
Bozza, Fernando A.
author_role author
author2 Bastos, Leonardo S. L.
Dantas, Leila F.
Zampieri, Fernando G.
Soares, Marcio
Hamacher, Silvio
Salluh, Jorge I. F.
Bozza, Fernando A.
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Kurtz, Pedro
Bastos, Leonardo S. L.
Dantas, Leila F.
Zampieri, Fernando G.
Soares, Marcio
Hamacher, Silvio
Salluh, Jorge I. F.
Bozza, Fernando A.
dc.subject.en.pt_BR.fl_str_mv Coronavirus
In-hospital mortality
Non-invasive ventilation
Respiratory support
topic Coronavirus
In-hospital mortality
Non-invasive ventilation
Respiratory support
description Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Hospital Copa Star. Rio de Janeiro, RJ, Brasil / Instituto Estadual do Cérebro Paulo Niemeyer. Rio de Janeiro, RJ, Brasil.
publishDate 2021
dc.date.accessioned.fl_str_mv 2021-05-21T13:32:46Z
dc.date.available.fl_str_mv 2021-05-21T13:32:46Z
dc.date.issued.fl_str_mv 2021
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv KURTZ, Pedro et al. Evolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 months. Intensive care medicine, p. 1–11, 2021
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/47288
dc.identifier.issn.pt_BR.fl_str_mv 0342-4642
dc.identifier.doi.none.fl_str_mv 10.1007/s00134-021-06388-0
identifier_str_mv KURTZ, Pedro et al. Evolving changes in mortality of 13,301 critically ill adult patients with COVID-19 over 8 months. Intensive care medicine, p. 1–11, 2021
0342-4642
10.1007/s00134-021-06388-0
url https://www.arca.fiocruz.br/handle/icict/47288
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Springer
publisher.none.fl_str_mv Springer
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/47288/1/license.txt
https://www.arca.fiocruz.br/bitstream/icict/47288/2/Envolving_Fernando_Bozza_etal_INI_2021.pdf
https://www.arca.fiocruz.br/bitstream/icict/47288/3/Envolving_Fernando_Bozza_etal_INI_2021.pdf.txt
bitstream.checksum.fl_str_mv 586c046dcfeef936e32f0323bb9a47c0
d7fe37abe6554191338055bfc738293f
45dcaaffe07ef76ce77712cbdea1b689
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
repository.name.fl_str_mv Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv repositorio.arca@fiocruz.br
_version_ 1798324741312872448

Registros relacionados