Hospital Mortality and Resource Implications of Hospitalisation with COVID-19 in London, UK: A Prospective Cohort Study
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 s...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2021/8832660 |
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| author | Savvas Vlachos Adrian Wong Victoria Metaxa Sergio Canestrini Carmen Lopez Soto Jimstan Periselneris Kai Lee Tanya Patrick Christopher Stovin Katrina Abernethy Budoor Albudoor Rishi Banerjee Fatimah Juma Sara Al-Hashimi William Bernal Ritesh Maharaj |
| author_facet | Savvas Vlachos Adrian Wong Victoria Metaxa Sergio Canestrini Carmen Lopez Soto Jimstan Periselneris Kai Lee Tanya Patrick Christopher Stovin Katrina Abernethy Budoor Albudoor Rishi Banerjee Fatimah Juma Sara Al-Hashimi William Bernal Ritesh Maharaj |
| author_sort | Savvas Vlachos |
| collection | DOAJ |
| 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. |
| format | Article |
| id | doaj-art-d07ba4df4af746ee8b21f3d9e10f6ff4 |
| institution | OA Journals |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-d07ba4df4af746ee8b21f3d9e10f6ff42025-08-20T02:20:02ZengWileyCritical Care Research and Practice2090-13052090-13132021-01-01202110.1155/2021/88326608832660Hospital Mortality and Resource Implications of Hospitalisation with COVID-19 in London, UK: A Prospective Cohort StudySavvas Vlachos0Adrian Wong1Victoria Metaxa2Sergio Canestrini3Carmen Lopez Soto4Jimstan Periselneris5Kai Lee6Tanya Patrick7Christopher Stovin8Katrina Abernethy9Budoor Albudoor10Rishi Banerjee11Fatimah Juma12Sara Al-Hashimi13William Bernal14Ritesh Maharaj15Department of Critical Care Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKDepartment of Critical Care Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKDepartment of Critical Care Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKDepartment of Critical Care Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKDepartment of Critical Care Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKDepartment of Respiratory Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKDepartment of Respiratory Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKDepartment of Respiratory Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKDepartment of Respiratory Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKDepartment of Respiratory Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKDepartment of Critical Care Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKDepartment of Critical Care Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKDepartment of Critical Care Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKDepartment of Critical Care Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKDepartment of Critical Care Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKDepartment of Critical Care Medicine, King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UKBackground. 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.http://dx.doi.org/10.1155/2021/8832660 |
| spellingShingle | Savvas Vlachos Adrian Wong Victoria Metaxa Sergio Canestrini Carmen Lopez Soto Jimstan Periselneris Kai Lee Tanya Patrick Christopher Stovin Katrina Abernethy Budoor Albudoor Rishi Banerjee Fatimah Juma Sara Al-Hashimi William Bernal Ritesh Maharaj Hospital Mortality and Resource Implications of Hospitalisation with COVID-19 in London, UK: A Prospective Cohort Study Critical Care Research and Practice |
| title | Hospital Mortality and Resource Implications of Hospitalisation with COVID-19 in London, UK: A Prospective Cohort Study |
| title_full | Hospital Mortality and Resource Implications of Hospitalisation with COVID-19 in London, UK: A Prospective Cohort Study |
| title_fullStr | Hospital Mortality and Resource Implications of Hospitalisation with COVID-19 in London, UK: A Prospective Cohort Study |
| title_full_unstemmed | Hospital Mortality and Resource Implications of Hospitalisation with COVID-19 in London, UK: A Prospective Cohort Study |
| title_short | Hospital Mortality and Resource Implications of Hospitalisation with COVID-19 in London, UK: A Prospective Cohort Study |
| title_sort | hospital mortality and resource implications of hospitalisation with covid 19 in london uk a prospective cohort study |
| url | http://dx.doi.org/10.1155/2021/8832660 |
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