Cited by 114COVID-19 Clinical Research StudiesSepsis Diagnosis and TreatmentRespiratory Support and Mechanisms

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Prognostic Factors for 30-Day Mortality in Critically Ill Patients With Coronavirus Disease 2019: An Observational Cohort Study

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Ferrando-Vivas, Paloma, Doidge, James, Thomas, Karen, Gould, Doug W., Mouncey, Paul, Shankar-Hari, Manu, Young, J. Duncan, Rowan, Kathryn M., Harrison, David A.·2021·Critical Care Medicine

DOI 10.1097/ccm.0000000000004740PMC PMC7737692

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Abstract

OBJECTIVES: To identify characteristics that predict 30-day mortality among patients critically ill with coronavirus disease 2019 in England, Wales, and Northern Ireland. DESIGN: Observational cohort study. SETTING: A total of 258 adult critical care units. PATIENTS: A total of 10,362 patients with confirmed coronavirus disease 2019 with a start of critical care between March 1, 2020, and June 22, 2020, of whom 9,990 were eligible (excluding patients with a duration of critical care less than 24 hr or missing core variables). MEASUREMENTS AND MAIN RESULTS: The main outcome measure was time to death within 30 days of the start of critical care. Of 9,990 eligible patients (median age 60 yr, 70% male), 3,933 died within 30 days of the start of critical care. As of July 22, 2020, 189 patients were still receiving critical care and a further 446 were still in acute hospital. Data were missing for between 0.1% and 7.2% of patients across prognostic factors. We imputed missing data ten-fold, using fully conditional specification and continuous variables were modeled using restricted cubic splines. Associations between the candidate prognostic factors and time to death within 30 days of the start of critical care were determined after adjustment for multiple variables with Cox proportional hazards modeling. Significant associations were identified for age, ethnicity, deprivation, body mass index, prior dependency, immunocompromise, lowest systolic blood pressure, highest heart rate, highest respiratory rate, Pa o 2/F io 2 ratio (and interaction with mechanical ventilation), highest blood lactate concentration, highest serum urea, and lowest platelet count over the first 24 hours of critical care. Nonsignificant associations were found for sex, sedation, highest temperature, and lowest hemoglobin concentration. CONCLUSIONS: We identified patient characteristics that predict an increased likelihood of death within 30 days of the start of critical care for patients with coronavirus disease 2019. These findings may support development of a prediction model for benchmarking critical care providers.

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Additional file 21 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019428
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Additional file 29 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019452
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Additional file 7 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019386
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Additional file 17 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019416
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Additional file 6 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019383
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Additional file 27 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019446
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Additional file 13 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019404
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Additional file 3 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019371
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Additional file 1 of Application of information from external data to correct for collider bias in a Covid-19 hospitalised cohort
Learoyd, A., Nicholas, J. M., Hart, N., & Douiri, A. (2024) · Figshare · doi:10.6084/m9.figshare.26749844
Additional file 2 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019368
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Additional file 15 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019410
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Additional file 2 of Epidemiology and outcomes of early-onset AKI in COVID-19-related ARDS in comparison with non-COVID-19-related ARDS: insights from two prospective global cohort studies
McNicholas, B. A., Rezoagli, E., Simpkin, A. J., Khanna, S., Suen, J. Y., Yeung, P., Brodie, D., Bassi, G. L., Pham, T. O., Bellani, G., et al. (2023) · Figshare · doi:10.6084/m9.figshare.22610959
Additional file 22 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019431
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Additional file 14 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019407
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Additional file 20 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019425
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Additional file 26 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019443
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Additional file 23 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019434
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Additional file 18 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019419
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Additional file 1 of Epidemiology and outcomes of early-onset AKI in COVID-19-related ARDS in comparison with non-COVID-19-related ARDS: insights from two prospective global cohort studies
McNicholas, B. A., Rezoagli, E., Simpkin, A. J., Khanna, S., Suen, J. Y., Yeung, P., Brodie, D., Bassi, G. L., Pham, T. O., Bellani, G., et al. (2023) · Figshare · doi:10.6084/m9.figshare.22610956
Additional file 8 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019389
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Additional file 16 of Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK
Bell, J. A., Carslake, D., Hughes, A., Tilling, K., Dodd, J. W., Doidge, J., Harrison, D. A., Rowan, K. M., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.27019413
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Authors: Ferrando-Vivas, P., Doidge, J., Thomas, K., Gould, D. W., Mouncey, P., Shankar-Hari, M., Young, J. D., Rowan, K. M., & Harrison, D. A.
Affiliations: Intensive Care National Audit & Research Centre (GB)
Intensive Care, Unit, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom.
Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
Intensive Care National Audit & Research Centre (ICNARC), London, United Kingdom.
ORCID: Ferrando-Vivas, Paloma
Doidge, James
Thomas, Karen
Gould, Doug W.
Mouncey, Paul
Harrison, David A.
Venue: Critical Care Medicine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2020-10-28
Volume: 49
Issue: 1
Pages: 102-111
ISSN: 0090-3493 (ISSN-L)
DOI: 10.1097/ccm.0000000000004740
PMC: PMC7737692
OpenAlex: W3097123511
Cited by: 113
References: 34
Citations by year: 2026: 3 · 2025: 3 · 2024: 43 · 2023: 15 · 2022: 26 · 2021: 21 · 2020: 2
FWCI: 2.10
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Critical Care Medicine (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Keywords: COVID-19 pandemic, 30-day mortality, prognostic factors, critically ill patients, intensive care, mortality prediction model, body mass index, immunocompromised patients, lactate, PaO2/FiO2 ratio, mechanical ventilation, blood pressure, platelet count, socioeconomic deprivation, ethnicity
MeSH terms: COVID-19, Adult, England, Female, Humans, Male, Middle Aged, Northern Ireland, Prognosis, Respiration, Artificial, Severity of Illness Index, Wales, Cohort Studies, Critical Illness, Hospital Mortality

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Prognostic Factors for 30-Day Mortality in Critically Ill Patients With Coronavirus Disease 2019: An Observational Cohort Study

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