Predisposing factors for admission to intensive care units of patients with COVID-19 infection - results of the German nationwide inpatient sample

BackgroundIntensive care units (ICU) capacities are one of the most critical determinants in health-care management of the COVID-19 pandemic. Therefore, we aimed to analyze the ICU-admission and case-fatality rate as well as characteristics and outcomes of patient admitted to ICU in order to identif...

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Hauptverfasser: Keller, Karsten (VerfasserIn) , Farmakis, Ioannis T. (VerfasserIn) , Valerio, Luca (VerfasserIn) , Koelmel, Sebastian (VerfasserIn) , Wild, Johannes (VerfasserIn) , Barco, Stefano (VerfasserIn) , Schmidt, Frank P. (VerfasserIn) , Espinola-Klein, Christine (VerfasserIn) , Konstantinides, Stavros (VerfasserIn) , Münzel, Thomas (VerfasserIn) , Sagoschen, Ingo (VerfasserIn) , Hobohm, Lukas (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 15 February 2023
In: Frontiers in Public Health
Year: 2023, Jahrgang: 11, Pages: 1-12
ISSN:2296-2565
DOI:10.3389/fpubh.2023.1113793
Online-Zugang:Resolving-System, lizenzpflichtig, Volltext: https://doi.org/10.3389/fpubh.2023.1113793
Verlag, lizenzpflichtig, Volltext: https://www.frontiersin.org/articles/10.3389/fpubh.2023.1113793
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Verfasserangaben:Karsten Keller, Ioannis T. Farmakis, Luca Valerio, Sebastian Koelmel, Johannes Wild, Stefano Barco, Frank P. Schmidt, Christine Espinola-Klein, Stavros Konstantinides, Thomas Münzel, Ingo Sagoschen and Lukas Hobohm

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520 |a BackgroundIntensive care units (ICU) capacities are one of the most critical determinants in health-care management of the COVID-19 pandemic. Therefore, we aimed to analyze the ICU-admission and case-fatality rate as well as characteristics and outcomes of patient admitted to ICU in order to identify predictors and associated conditions for worsening and case-fatality in this critical ill patient-group.MethodsWe used the German nationwide inpatient sample to analyze all hospitalized patients with confirmed COVID-19 diagnosis in Germany between January and December 2020. All hospitalized patients with confirmed COVID-19 infection during the year 2020 were included in the present study and were stratified according ICU-admission.ResultsOverall, 176,137 hospitalizations of patients with COVID-19-infection (52.3% males; 53.6% aged ≥70 years) were reported in Germany during 2020. Among them, 27,053 (15.4%) were treated in ICU. COVID-19-patients treated on ICU were younger [70.0 (interquartile range (IQR) 59.0-79.0) vs. 72.0 (IQR 55.0-82.0) years, P < 0.001], more often males (66.3 vs. 48.8%, P < 0.001), had more frequently cardiovascular diseases (CVD) and cardiovascular risk-factors with increased in-hospital case-fatality (38.4 vs. 14.2%, P < 0.001). ICU-admission was independently associated with in-hospital death [OR 5.49 (95% CI 5.30-5.68), P < 0.001]. Male sex [OR 1.96 (95% CI 1.90-2.01), P < 0.001], obesity [OR 2.20 (95% CI 2.10-2.31), P < 0.001], diabetes mellitus [OR 1.48 (95% CI 1.44-1.53), P < 0.001], atrial fibrillation/flutter [OR 1.57 (95% CI 1.51-1.62), P < 0.001], and heart failure [OR 1.72 (95% CI 1.66-1.78), P < 0.001] were independently associated with ICU-admission.ConclusionDuring 2020, 15.4% of the hospitalized COVID-19-patients were treated on ICUs with high case-fatality. Male sex, CVD and cardiovascular risk-factors were independent risk-factors for ICU admission. 
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