ArticlePloS one2021
A national retrospective study of the association between serious operational problems and COVID-19 specific intensive care mortality risk.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Likelihood of COVID-19 reinfection in an urban community cohort in Massachusetts.Dialogues in health · 2022Article
- Replicates Number for Drug Stability Testing during Bioanalytical Method Validation-An Experimental and Retrospective Approach.Molecules (Basel, Switzerland) · 2022Article
- The association between mechanical ventilator compatible bed occupancy and mortality risk in intensive care patients with COVID-19: a national retrospective cohort study.BMC medicine · 2021Observational
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo describe the relationship between reported serious operational problems (SOPs), and mortality for patients with COVID-19 admitted to intensive care units (ICUs).
designEnglish national retrospective cohort study.
setting89 English hospital trusts (i.e. small groups of hospitals functioning as single operational units). PATIENTS: All adults with COVID-19 admitted to ICU between 2nd April and 1st December, 2020 (n = 6,737).
interventionsN/A. MAIN OUTCOMES AND MEASURES: Hospital trusts routinely submit declarations of whether they have experienced 'serious operational problems' in the last 24 hours (e.g. due to staffing issues, adverse weather conditions, etc.). Bayesian hierarchical models were used to estimate the association between in-hospital mortality (binary outcome) and: 1) an indicator for whether a SOP occurred on the date of a patient's admission, and; 2) the proportion of the days in a patient's stay that had a SOP occur within their trust. These models were adjusted for individual demographic characteristics (age, sex, ethnicity), and recorded comorbidities.
resultsSerious operational problems (SOPs) were common; reported in 47 trusts (52.8%) and were present for 2,701 (of 21,716; 12.4%) trust days. Overall mortality was 37.7% (2,539 deaths). Admission during a period of SOPs was associated with a substantially increased mortality; adjusted odds ratio (OR) 1.34 (95% posterior credible interval (PCI): 1.07 to 1.68). Mortality was also associated with the proportion of a patient's admission duration that had concurrent SOPs; OR 1.47 (95% PCI: 1.10 to 1.96) for mortality where SOPs were present for 100% compared to 0% of the stay. CONCLUSION AND RELEVANCE: Serious operational problems at the trust-level are associated with a significant increase in mortality in patients with COVID-19 admitted to critical care. The link isn't necessarily causal, but this observation justifies further research to determine if a binary indicator might be a valid prognostic marker for deteriorating quality of care.
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