Using data science techniques, the team revealed that the NHS trust in which a COVID-19 patient ended up in intensive care is as important, in terms of the risk of death, as the strongest patient-specific risk factors such as older age, immunosuppression or chronic heart/kidney disease. In the worst case, COVID-19 patients in the intensive care unit (ICU) of a particular NHS trust were over four times as likely to die in a given time period than COVID-19 patients in an average trust’s ICU.
From the earliest days of the coronavirus pandemic, clinicians and scientists have been deciphering the risk factors that make someone with COVID-19 more likely to die. The uncovering of determinants of risk has allowed doctors to focus resources on the most vulnerable patients and has proved important in planning for the surge in demand for intensive care units created by the pandemic. It has also informed the public of which groups should take greater measures to shield or socially distance themselves. The new study is the first to reveal the extent to which ICU-patient location is a factor.
“COVID-19 has stretched most ICUs well beyond their normal capacity and necessitated them finding additional space, equipment and skilled staff – in an already stretched NHS – to deal with demand for highly specialist life-supporting therapies,” says Dr Ercole. “It is possible that some hospitals found this harder either because they didn’t have time to react or the necessary resources. It is crucial to understand the reasons for these between-centre differences as we plan our response to similar situations in the future: how and where to build capacity, and how to use what we have most effectively.”
The peer-reviewed paper – “Between-centre differences for COVID-19 ICU mortality from early data in England” – has been accepted for publication in Intensive Care Medicine. A preprint of the study, posted prior to the completion of peer-review, is available online.
Image: Coronavirus
Credit: Yuri Samoilov
Reproduced courtesy of the University of Cambridge