Evidence map›Paper›PMID 36261587›Full record

ArticleScientific reports2022

A retrospective cohort study comparing differences in 30-day mortality among critically ill patients aged ≥ 70 years treated in European tax-based healthcare systems (THS) versus social health insurance systems.

Bernhard Wernly, Hans Flaatten, Michael Beil, Jesper Fjølner, Raphael Romano Bruno, Antonio Artigas, Bernardo Bollen Pinto, Joerg C Schefold, Malte Kelm, Sviri Sigal and 17 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Bernhard WernlyCenter for Public Health and Healthcare Research, Paracelsus Medical University of Salzburg, 5020, Salzburg, Austria.
Hans FlaattenDepartment of Clinical Medicine, University of Bergen, Bergen, Norway.
Michael BeilDeptartment of Medical Intensive Care, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, 91120, Jersualem, Israel.
Jesper FjølnerDepartment of Anesthesia and Intensive Care, Viborg Regional Hospital, 8800, Viborg, Denmark.
Raphael Romano BrunoDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
Antonio ArtigasDepartment of Intensive Care Medicine, CIBER Enfermedades Respiratorias, Corporacion Sanitaria Universitaria Parc Tauli, Autonomous University of Barcelona, 08208, Sabadell, Spain.
Bernardo Bollen PintoDepartment of Acute Medicine, Geneva University Hospitals, 1205, Geneva, Switzerland.
Joerg C SchefoldDepartment of Intensive Care Medicine, Inselspital, Universitätsspital, University of Bern, 3010, Bern, Switzerland.
Malte KelmDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
Sviri SigalDeptartment of Medical Intensive Care, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, 91120, Jersualem, Israel.
Peter Vernon van HeerdenDeptartment of Anesthesia, Intensive Care and Pain Medicine, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, 91120, Jerusalem, Israel.
Wojciech SzczeklikCenter for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, 31-008, Krakow, Poland.
Muhammed ElhadiFaculty of Medicine, University of Tripoli, R6XF+46G, Tripoli, Libya.
Michael JoannidisDivision of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, 6020, Innsbruck, Austria.
Richard RezarClinic of Internal Medicine II, Department of Cardiology and Intensive Care, Paracelsus Medical University of Salzburg, 5020, Salzburg, Austria.
Sandra OeyenDepartment of Intensive Care 1K12IC, Ghent University Hospital, 9000, Ghent, Belgium.
Georg WolffDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
Brian MarshMater Misericordiae University Hospital, Dublin, D07 R2WY, Ireland.
Finn H AndersenDepartment of Anaesthesia and Intensive Care, Ålesund Hospital, 6017, Ålesund, Norway.
Rui MorenoCentro Hospitalar de Lisboa Central, Lisbon, Portugal.
Sarah WernlyDepartment of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, 5020, Salzburg, Austria.
Susannah LeaverGeneral Intensive Care, St. George´s University Hospital NHS Foundation Trust, London, SW17 0QT, UK.
Ariane BoumendilInserm, Service de réanimation, Institut Pierre-Louis d'épidémiologie et de Santé Publique, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, 184, Rue du Faubourg-Saint-Antoine, 75012, Paris, France.
Dylan W De LangeDepartment of Intensive Care Medicine, University Medical Center, University Utrecht, 3584 CX, Utrecht, The Netherlands.
Bertrand GuidetInserm, Service de réanimation, Institut Pierre-Louis d'épidémiologie et de Santé Publique, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, 184, Rue du Faubourg-Saint-Antoine, 75012, Paris, France.
Stefan PeringsDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
Christian JungDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Duesseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany. christian.jung@med.uni-duesseldorf.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In Europe, tax-based healthcare systems (THS) and social health insurance systems (SHI) coexist. We examined differences in 30-day mortality among critically ill patients aged ≥ 70 years treated in intensive care units in a THS or SHI. Retrospective cohort study. 2406 (THS n = 886; SHI n = 1520) critically ill ≥ 70 years patients in 129 ICUs. Generalized estimation equations with robust standard errors were chosen to create population average adjusted odds ratios (aOR). Data were adjusted for patient-specific variables, organ support and health economic data. The primary outcome was 30-day-mortality. Numerical differences between SHI and THS in SOFA scores (6 ± 3 vs. 5 ± 3; p = 0.002) were observed, but clinical frailty scores were similar (> 4; 17% vs. 14%; p = 0.09). Higher rates of renal replacement therapy (18% vs. 11%; p < 0.001) were found in SHI (aOR 0.61 95%CI 0.40-0.92; p = 0.02). No differences regarding intubation rates (68% vs. 70%; p = 0.33), vasopressor use (67% vs. 67%; p = 0.90) and 30-day-mortality rates (47% vs. 50%; p = 0.16) were found. Mortality remained similar between both systems after multivariable adjustment and sensitivity analyses. The retrospective character of this study. Baseline risk and mortality rates were similar between SHI and THS. The type of health care system does not appear to have played a role in the intensive care treatment of critically ill patients ≥ 70 years with COVID-19 in Europe.

Indexed as

COVID-19Critical IllnessDelivery of Health CareHumansInsurance, HealthIntensive Care UnitsRetrospective Studies

Identifiers

PMID36261587
PMCPMC9580441

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.