Abstract

Background

To assess trends in the quality of care for COVID-19 patients at the ICU over the course of time in the Netherlands.

Methods

Data from the National Intensive Care Evaluation (NICE)-registry of all COVID-19 patients admitted to an ICU in the Netherlands were used. Patient characteristics and indicators of quality of care during the first two upsurges (N = 4215: October 5, 2020–January 31, 2021) and the final upsurge of the second wave, called the ‘third wave’ (N = 4602: February 1, 2021–June 30, 2021) were compared with those during the first wave (N = 2733, February–May 24, 2020).

Results

During the second and third wave, there were less patients treated with mechanical ventilation (58.1 and 58.2%) and vasoactive drugs (48.0 and 44.7%) compared to the first wave (79.1% and 67.2%, respectively). The occupancy rates as fraction of occupancy in 2019 (1.68 and 1.55 vs. 1.83), the numbers of ICU relocations (23.8 and 27.6 vs. 32.3%) and the mean length of stay at the ICU (HRs of ICU discharge = 1.26 and 1.42) were lower during the second and third wave. No difference in adjusted hospital mortality between the second wave and the first wave was found, whereas the mortality during the third wave was considerably lower (OR = 0.80, 95% CI [0.71–0.90]).

Conclusions

These data show favorable shifts in the treatment of COVID-19 patients at the ICU over time. The adjusted mortality decreased in the third wave. The high ICU occupancy rate early in the pandemic does probably not explain the high mortality associated with COVID-19.

Details

Title
Characteristics and outcome of COVID-19 patients admitted to the ICU: a nationwide cohort study on the comparison between the first and the consecutive upsurges of the second wave of the COVID-19 pandemic in the Netherlands
Author
Dongelmans, Dave A 1 ; Termorshuizen Fabian 2   VIAFID ORCID Logo  ; Brinkman, Sylvia 2 ; Bakhshi-Raiez Ferishta 2 ; Sesmu, Arbous M 3 ; de Lange Dylan W 4 ; van Bussel Bas C T 5 ; de Keizer Nicolette F 6 ; Verbiest, Dirk P; te Velde Leo F; van Driel Erik M; Rijpstra Tom; Elbers, Paul W, G; Georgieva Lyuba; Verweij, Eva; de Jong Remko M; van Iersel Freya M; Koning Dick T J J; Rengers Els; Kusadasi Nuray; Erkamp, Michiel L; van den Berg Roy; Jacobs Cretièn J M G; Epker, Jelle L; Rijkeboer, Annemiek A; de Bruin Martha T; Spronk, Peter; Draisma Annelies; Versluis, Dirk Jan; van den Berg Lettie A E; Mos Marissa Vrolijk-de; Lens, Judith A; Jannet, Mehagnoul-Schipper D; Gommers Diederik; Lutisan, Johan G; Hoeksema Martijn; Pruijsten, Ralph V; Kieft, Hans; Rozendaal, Jan; Nooteboom Fleur; Boer, Dirk P; Janssen Inge T A; van Gulik Laura; Peter, Koetsier M; Silderhuis, Vera M; Schnabel, Ronny M; Drogt Ioana; de Ruijter Wouter; Bosman, Rob J; Frenzel, Tim; Urlings-Strop Louise C; Allard, Dijkhuizen; Hené, Ilanit Z; de Meijer Arthur R; Holtkamp Jessica W M; Postma Nynke; Bindels Alexander J G H; Wesselink Ronald M J; van Slobbe-Bijlsma Eline R; van der Voort Peter H J; Eikemans Bob J W; Barnas Michel G W; Festen-Spanjer Barbara; van Lieshout Maarten; Gritters, Niels C; van Tellingen Martijn; Brunnekreef, Gert B; Vandeputte, Joyce; Dormans Tom P J; Hoogendoorn, Marga E; de Graaff Mart; Moolenaar, David; Reidinga, Auke C; Spijkstra Jan Jaap; de Waal Ruud

1  National Intensive Care Evaluation (NICE) Foundation, Amsterdam, The Netherlands; Amsterdam UMC, University of Amsterdam, Department of Intensive Care Medicine, Amsterdam, The Netherlands (GRID:grid.7177.6) (ISNI:0000000084992262) 
2  National Intensive Care Evaluation (NICE) Foundation, Amsterdam, The Netherlands (GRID:grid.7177.6); Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands (GRID:grid.7177.6) (ISNI:0000000084992262) 
3  National Intensive Care Evaluation (NICE) Foundation, Amsterdam, The Netherlands (GRID:grid.7177.6); Leiden University Medical Center, Department of Intensive Care Medicine, Leiden, The Netherlands (GRID:grid.10419.3d) (ISNI:0000000089452978) 
4  National Intensive Care Evaluation (NICE) Foundation, Amsterdam, The Netherlands (GRID:grid.10419.3d); University Medical Center, University of Utrecht, Department of Intensive Care Medicine, Utrecht, The Netherlands (GRID:grid.5477.1) (ISNI:0000000120346234) 
5  Maastricht University Medical Centre+, Department of Intensive Care Medicine, Maastricht, The Netherlands (GRID:grid.412966.e) (ISNI:0000 0004 0480 1382); Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands (GRID:grid.5012.6) (ISNI:0000 0001 0481 6099) 
6  National Intensive Care Evaluation (NICE) Foundation, Amsterdam, The Netherlands (GRID:grid.5012.6); Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands (GRID:grid.7177.6) (ISNI:0000000084992262) 
Publication year
2022
Publication date
Dec 2022
Publisher
Springer Nature B.V.
e-ISSN
21105820
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s13613-021-00978-3
ProQuest document ID
2619338419
Copyright
© The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.