To describe and compare the clinical characteristics and outcomes of patients admitted to intensive care units during the first and second waves of the COVID-19 pandemic.
In this retrospective ...single-center cohort study, data were retrieved from the Epimed Monitor System; all adult patients admitted to the intensive care unit between March 4, 2020, and October 1, 2021, were included in the study. We compared the clinical characteristics and outcomes of patients admitted to the intensive care unit of a quaternary private hospital in São Paulo, Brazil, during the first (May 1, 2020, to August 31, 2020) and second (March 1, 2021, to June 30, 2021) waves of the COVID-19 pandemic.
In total, 1,427 patients with COVID-19 were admitted to the intensive care unit during the first (421 patients) and second (1,006 patients) waves. Compared with the first wave group median (IQR), the second wave group was younger 57 (46-70) versus 67 (52-80) years; p<0.001, had a lower SAPS 3 Score 45 (42-52) versus 49 (43-57); p<0.001, lower SOFA Score on intensive care unit admission 3 (1-6) versus 4 (2-6); p=0.018, lower Charlson Comorbidity Index 0 (0-1) versus 1 (0-2); p<0.001, and were less frequently frail (10.4% versus 18.1%; p<0.001). The second wave group used more noninvasive ventilation (81.3% versus 53.4%; p<0.001) and high-flow nasal cannula (63.2% versus 23.0%; p<0.001) during their intensive care unit stay. The intensive care unit (11.3% versus 10.5%; p=0.696) and in-hospital mortality (12.3% versus 12.1%; p=0.998) rates did not differ between both waves.
In the first and second waves, patients with severe COVID-19 exhibited similar mortality rates and need for invasive organ support, despite the second wave group being younger and less severely ill at the time of intensive care unit admission.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
•Health care-associated infections are an important public health and patient safety issue.•A bundle is a specific tool with clear parameters to guide the multidisciplinary team in the intensive care ...unit.•Central line-associated blood stream infection, catheter-associated urinary tract infection, and ventilator-associated pneumonia rates declined 58.6%, 56.7%, and 82.6%, respectively, after bundle implementation.
A retrospective cohort study was conducted to evaluate the bundle of techniques developed by the multidisciplinary team to minimize infections in an adult intensive care unit over a 22-year span. Two periods were analyzed: 1996-2006 and 2007-2017. Bloodstream infections, urinary tract infections, and ventilator-associated pneumonia declined 58.6%, 56.7%, and 82.6%, respectively (P < .05) from 2007 to 2017 compared with these same infections during 1996-2006.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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