학술논문
Hospital Variation in Management and Outcomes of Acute Respiratory Distress Syndrome Due to COVID-19
Document Type
article
Author
Shelsey W. Johnson, MD; Michael A. Garcia, MD; Emily K. Q. Sisson, MA; Christopher R. Sheldrick, PhD; Vishakha K. Kumar, MD, MBA; Karen Boman, BA; Scott Bolesta, PharmD; Vikas Bansal, MBBS, MPH; Amos Lal, MBBS; J. P. Domecq, MD, MS; Roman R. Melamed, MD; Amy B. Christie, MD; Abdurrahman Husain, MD; Santiago Yus, MBBS; Ognjen Gajic, MD, MSc; Rahul Kashyap, MBBS, MBA; Allan J. Walkey, MD, MSc; from the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group; Oscar Y. Gavidia; Felipe Pachon; Yeimy A. Sanchez; Mohamed El Kassas; Mohamed Badr; Ahmed Tawheed; Hend Yahia; Wataru Matsuda; Reina Suzuki; Masamitsu Sanui; Sho Horikita; Yuki Itagaki; Akira Kodate; Yuki Takahashi; Koyo Moriki; Muhammad Sohaib; Asghar, Mashaal Syed; Syed Anosh; Ali Naqvi; Borisovich Zabolotskikh; Konstantin Dmitrievich Zybin; Sergey Vasilevich Sinkov; Tatiana Sergeevna Musaeva; Mohammed A. Almazyad; Mohammed I. Alarifi; Jara M. Macarambon; Ahmad Abdullah Bukhari; Hussain A. Albahrani; Kazi N. Asfina; Kaltham M. Aldossary; Marija Zdravkovic; Zoran Todorovic; Viseslav Popadic; Slobodan Klasnja; Predrag D. Stevanovic; Dejan S. Stojakov; Duska K. Ignjatovic; Suzana C. Bojic; Marina M. Bobos; Irina B. Nenadic; Milica S. Zaric; Marko D. Djuric; Vladimir R. Djukic; Santiago Yus; Belen C. Martin; Uluhan Sili; Huseyin Bilgin; Pinar Ay; Roman R. Melamed; David M. Tierney; Love A. Patel; Vino S. Raj; Barite U. Dawud; Narayana Mazumder; Abbey Sidebottom; Alena M. Guenther; Benjamin D. Krehbiel; Nova J. Schmitz; Stacy L. Jepsen; Lynn Sipsey; Anna Schulte; Whitney Wunderlich; Cecely Hoyt; Kenneth W. Dodd; Nicholas Goodmanson; Kathleen Hesse; Paige Bird; Chauncey Weinert; Nathan Schoenrade; Abdulrahman Altaher; Esmael Mayar; Matthew Aronson; Tyler Cooper; Monica Logan; Brianna Miner; Gisele Papo; Abdulrahman Al-Fares; Anmol Kharbanda; Sunil Jhajhria; Zachary Fyffe; Amy B. Christie; Dennis W. Ashley; Rajani Adiga; Andrea Sikora Newsome; Christy C. Forehand; Rebecca Bruning; Timothy W. Jones; Moldovan Sabov; Fatema Zaidi; Fiona Tissavirasingham; Dhatri Malipeddi; Valerie M. Banner-Goodspeed; Somnath Bose; Lauren E. Kelly; Melisa Joseph; Marie McGourty; Krystal Capers; Benjamin Hoenig; Maria C. Karamourtopoulos; Anica C. Law; Elias N. Baedorf Kassis; Allan J. Walkey; Sushrut S. Waikar; Michael A. Garcia; Mia Colona; Zoe Kibbelaar; Michael Leong; Daniel Wallman; Kanupriya Soni; Jennifer Maccarone; Joshua Gilman; Ycar Devis; Joseph Chung; Munizay Paracha; David N. Lumelsky; Madeline DiLorenzo; Najla Abdurrahman; Shelsey Johnson; Kimberly Zammit; Patrick J. McGrath; William Loeffler; Maya R. Chilbert; Jean-Baptiste Mesland; Pierre Henin; Hélène Petre; Isabelle Buelens; Anne-Catherine Gerard; Rayan E. Ihle; Shelda A. Martin; Elaine A. Davis; Salim Surani; Joshua White; Aftab Khan; Rahul Dhahwal; Sreekanth Cheruku; Farzin Ahmed; Christopher Deonarine; Ashley Jones; Mohammad-Ali Shaikh; David Preston; Jeanette Chin; Steven K. Daugherty; Sam Atkinson; Kelly Shrimpton; Raquel R. Bartz; Vijay Krishnamoorthy; Bryan Kraft; Aaron Pulsipher; Eugene Friedman; Sachin Mehta; David P. Yamane; Ivy Benjenk; Nivedita Prasanna; Katharine Nault; Ronald A. Reilkoff; Julia A. Heneghan; Sarah Eichen; Lexie Goertzen; Scott Rajala; Ghislaine Feussom; Ben Tang; Mayo Clinic Arizona; Rodrigo Cartin-Ceba; Ayan Sen; Amanda Palacios; Giyth M. Mahdi; Rahul Kashyap; Ognjen Gajic; Vikas Bansal; Aysun Tekin; Amos Lal; John C. O’Horo; Neha N. Deo; Mayank Sharma; Shahraz Qamar; Juan Pablo Domecq; Romil Singh; Alex Niven; Mayo Clinic; Eau Claire; Abigail T. La Nou; Marija Bogojevic; Barbara Mullen; Devang Sanghavi; Pramod Guru; Pablo Moreno Franco; Karthik Gnanapandithan; Hollie Saunders; Zachary Fleissner; Juan Garcia; Alejandra Yu Lee Mateus; Siva Naga Yarrarapu; Nirmaljot Kaur; Abhisekh Giri; Syed Anjum Khan; Nitesh Kumar Jain; Thoyaja Koritala; Chakradhar Venkata; Miriam Engemann; Annamarie Mantese; Yasir Tarabichi; Adam Perzynski; Christine Wang; Dhatri Kotekal; Bhagat S. Aulakh; Sandeep Tripathi; Jennifer A. Bandy; Lisa M. Kreps; Dawn R. Bollinger; Roger Scott Stienecker; Andre G. Melendez; Tressa A. Brunner; Sue M. Budzon; Jessica L. Heffernan; Janelle M. Souder; Tracy L. Miller; Andrea G. Maisonneuve; Antonia L. Vilella; Sara B. Kutner; Kacie Clark; Danielle Moore; Harry L. Anderson, III; Dixy Rajkumar; Ali Abunayla; Jerrilyn Heiter; Howard A. Zaren; Stephanie J. Smith; Grant C. Lewis; Lauren Seames; Cheryl Farlow; Judy Miller; Gloria Broadstreet; Anthony Martinez; Micheal Allison; Aniket Mittal; Rafael Ruiz; Aleta Skaanland; Robert Ross; Neha Gupta; Tracy L. Jones; Shonda C. Ayers; Amy B. Harrell; Dr. Brent R. Brown; Abdurrahman Husain; Atul Malhotra; Qais Zawaydeh; Dragana Markotić; Ivana Bošnjak; Emily A. Vail; Susannah Nicholson; Rachelle B. Jonas; AnnaRose E. Dement; William Tang; Mark DeRosa; Robert E. Villarreal; Patrick W. McGonagill; Colette Galet; Janice Hubbard; David Wang; Lauren Allan; Aditya Badheka; Madhuradhar Chegondi; Roger A. Alvarez; Amarilys Alarcon-Calderon; Marie Anne Sosa; Sunita K. Mahabir; Mausam J. Patel; Faraaz Ali Shah; Byron Chuan; Sagar L. Rawal; Manal Piracha; Joseph E. Tonna; Nicholas M. Levin; Kayte Suslavich; Rachel Tsolinas; Zachary T. Fica; Chloe R. Skidmore; Renee D. Stapleton; Anne E. Dixon; Olivia Johnson; Sara S. Ardren; Stephanie Burns; Anna Raymond; Erika Gonyaw; Kevin Hodgdon; Chloe Housenger; Benjamin Lin; Karen McQuesten; Heidi Pecott-Grimm; Julie Sweet; Sebastian Ventrone; Murtaza Akhter; Rania Abdul Rahman; Mary Mulrow; Ashish K. Khanna; Lynne Harris; Bruce Cusson; Jacob Fowler; David Vaneenenaam; Glen McKinney; Imoh Udoh; Kathleen Johnson; Vishwanath Pattan; Jessica Papke; Ismail Jimada; Nida Mhid; Samuel Chakola
Source
Critical Care Explorations, Vol 10, Iss 2, p e0638 (2022)
Subject
Language
English
ISSN
2639-8028
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Abstract
OBJECTIVES:. To describe hospital variation in use of “guideline-based care” for acute respiratory distress syndrome (ARDS) due to COVID-19. DESIGN:. Retrospective, observational study. SETTING:. The Society of Critical Care Medicine’s Discovery Viral Infection and RESPIRATORY ILLNESS UNIVERSAL STUDY COVID-19 REGISTRY. PATIENTS:. Adult patients with ARDS due to COVID-19 between February 15, 2020, and April 12, 2021. INTERVENTIONS:. Hospital-level use of “guideline-based care” for ARDS including low-tidal-volume ventilation, plateau pressure less than 30 cm H2O, and prone ventilation for a Pao2/Fio2 ratio less than 100. MEASUREMENTS AND MAIN RESULTS:. Among 1,495 adults with COVID-19 ARDS receiving care across 42 hospitals, 50.4% ever received care consistent with ARDS clinical practice guidelines. After adjusting for patient demographics and severity of illness, hospital characteristics, and pandemic timing, hospital of admission contributed to 14% of the risk-adjusted variation in “guideline-based care.” A patient treated at a randomly selected hospital with higher use of guideline-based care had a median odds ratio of 2.0 (95% CI, 1.1–3.4) for receipt of “guideline-based care” compared with a patient receiving treatment at a randomly selected hospital with low use of recommended therapies. Median-adjusted inhospital mortality was 53% (interquartile range, 47–62%), with a nonsignificantly decreased risk of mortality for patients admitted to hospitals in the highest use “guideline-based care” quartile (49%) compared with the lowest use quartile (60%) (odds ratio, 0.7; 95% CI, 0.3–1.9; p = 0.49). CONCLUSIONS:. During the first year of the COVID-19 pandemic, only half of patients received “guideline-based care” for ARDS management, with wide practice variation across hospitals. Strategies that improve adherence to recommended ARDS management strategies are needed.