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- Predicting factors associated with prolonged intensive care unit stay of patients with COVID-19
- Won Ho Han, Jae Hoon Lee, June Young Chun, Young Ju Choi, Youseok Kim, Mira Han, Jee Hee Kim
- Acute Crit Care. 2023;38(1):41-48. Published online February 22, 2023
- DOI: https://doi.org/10.4266/acc.2022.01235
- 3,114 View
- 96 Download
- 2 Web of Science
- 2 Crossref
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Abstract
PDF - Background
Predicting the length of stay (LOS) for coronavirus disease 2019 (COVID-19) patients in the intensive care unit (ICU) is essential for efficient use of ICU resources. We analyzed the clinical characteristics of patients with severe COVID-19 based on their clinical care and determined the predictive factors associated with prolonged LOS. Methods: We included 96 COVID-19 patients who received oxygen therapy at a high-flow nasal cannula level or above after ICU admission during March 2021 to February 2022. The demographic characteristics at the time of ICU admission and results of severity analysis (Sequential Organ Failure Assessment [SOFA], Acute Physiology and Chronic Health Evaluation [APACHE] II), blood tests, and ICU treatments were analyzed using a logistic regression model. Additionally, blood tests (C-reactive protein, D-dimer, and the PaO2 to FiO2 ratio [P/F ratio]) were performed on days 3 and 5 of ICU admission to identify factors associated with prolonged LOS. Results: Univariable analyses showed statistically significant results for SOFA score at the time of ICU admission, C-reactive protein level, high-dose steroids, mechanical ventilation (MV) care, continuous renal replacement therapy, extracorporeal membrane oxygenation, and prone position. Multivariable analysis showed that MV care and P/F ratio on hospital day 5 were independent factors for prolonged ICU LOS. For D-dimer, no significant variation was observed at admission; however, after days 3 and 5 days of admission, significant between-group variation was detected. Conclusions: MV care and P/F ratio on hospital day 5 are independent factors that can predict prolonged LOS for COVID-19 patients. -
Citations
Citations to this article as recorded by
- Predictors of prolonged ventilator weaning and mortality in critically ill patients with COVID-19
Marcella M Musumeci, Bruno Valle Pinheiro2, Luciana Dias Chiavegato1, Danielle Silva Almeida Phillip1, Flavia R Machado3, FabrÃcio Freires3, Osvaldo Shigueomi Beppu1, Jaquelina Sonoe Ota Arakaki1, Roberta Pulcheri Ramos1
Jornal Brasileiro de Pneumologia.2023; : e20230131. CrossRef - The distorted memories of patients treated in the intensive care unit during the COVID-19 pandemic: A qualitative study
Gisela Vogel, Ulla Forinder, Anna Sandgren, Christer Svensen, Eva Joelsson-Alm
Intensive and Critical Care Nursing.2023; 79: 103522. CrossRef
- Predictors of prolonged ventilator weaning and mortality in critically ill patients with COVID-19
- Energy Deficiency Aggravates Clinical Outcomes of Critically Ill Patients
- Hye Kyung Chung, Song Mi Lee, Jae Hoon Lee, Cheung Soo Shin
- Korean J Crit Care Med. 2005;20(1):49-53.
- 1,825 View
- 29 Download
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Abstract
PDF
- BACKGROUND
Adequate nutrition support reduces infectious complications, mortality and length of hospitalizationin intensive care unit. However, there are multi factors like frequent null per os (NPO) due to examination, intolerance to tube feeding, complication of TPN (total parenteral nutrition) and ineffective recognition by medical staff. The purpose of this study is to identify detrimental effects of cumulative energy deficiency in critically ill patients.
METHODS
The patients who were received tube feeding or total parenteral nutrition for more than 5 days were investigated. Daily and cumulative energy deficiency was tabulated until oral intake was achieved or until they discharged or died. Patients were divided into two groups, severe energy deficient group (>10, 000 kcal) or mild energy deficient group (<5, 000 kcal). Then we compared clinical outcomes between two groups. RESULTS: Total 150 patients were studied. 48 (32%) patients were severe energy deficient group and 42 (28%) patients were mild energy deficient group. Mortality and nosocomial infection were significantly higher in severe energy deficient group than in mild group. Hospital day and ICU day were significantly higher in severe energy deficient group than in mild group. CONCLUSIONS: Severe energy deficiency was very common in critically ill patients and it deteriorated the clinical outcomes such as mortality, nosocomial infection, hospital day and ICU day.
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