Delayed intubation is associated with mortality in patients with severe COVID-19: A single-centre observational study in Switzerland - 26/07/22
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Highlights |
• | Delayed intubation in severe COVID-19 patients associated with mortality. |
Abstract |
Introduction |
Switzerland experienced two waves of COVID-19 in 2020, but with a different ICU admission and treatment management strategy. The timing of ICU admission and intubation remains a matter of debate in severe patients. The aim of our study was to describe the characteristics of ICU patients between two subsequent waves of COVID-19 who underwent a different management strategy and to assess whether the timing of intubation was associated with differences in mortality.
Patients and methods |
We conducted a prospective observational study of all adult patients with acute respiratory failure due to COVID-19 who required intubation between the 9th of March 2020 and the 9th of January 2021 in the intensive care unit (ICU) at Geneva University Hospitals, Switzerland.
Results |
Two hundred twenty-three patients were intubated during the study period; 124 during the first wave, and 99 during the second wave. Patients admitted to the ICU during the second wave had a higher SAPS II severity score (52.5 vs. 60; p = 0.01). The time from hospital admission to intubation was significantly longer during the second compared to the first wave (4 days [IQR, 1-7] vs. 2 days [IQR, 0-4]; p < 0.01). All-cause ICU mortality was significantly higher during the second wave (42% vs. 23%; p < 0.01). In a multivariate analysis, the delay between hospital admission and intubation was significantly associated with ICU mortality (OR 3.25 [95% CI, 1.38-7.67]; p < 0.05).
Conclusions |
In this observational study, delayed intubation was associated with increased mortality in patients with severe COVID-19. Further randomised controlled trials are needed.
Le texte complet de cet article est disponible en PDF.Keywords : Acute respiratory distress syndrome, COVID-19, intensive care unit, mortality, timing intubation, delayed intubation
Plan
Vol 41 - N° 4
Article 101092- août 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.