Evidence map›Paper›PMID 39905298›Full record

Observational studyBMC infectious diseases2025

Regional differences in triage decisions affect hospital mortality among frail COVID-19 patients in the COvid MEdicaTion study.

Julia Minnema, Roos Sablerolles, Janneke van Kempen, Hugo van der Kuy, Harmke Polinder-Bos, Bob van de Loo, Jorie Versmissen, Miriam L Haaksma, Melvin Lafeber, Miriam C Faes and 1 more

Erratum issuedAbstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. 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

5 · Who and what money

Authors and funding

11 authors.

Julia Minnema *Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. j.minnema@erasmusmc.nl.
Roos Sablerolles *Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Janneke van KempenDepartment of Geriatrics, Amphia Hospital, Breda, the Netherlands.
Hugo van der KuyDepartment of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Harmke Polinder-BosDepartment of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Bob van de LooDigitalis Rx BV, Amsterdam, the Netherlands.
Jorie VersmissenDepartment of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Miriam L HaaksmaDepartment of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands.
Melvin Lafeber *Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Miriam C Faes *Department of Geriatrics, Amphia Hospital, Breda, the Netherlands.
COMET research team^

Funding

ZonMw 10430102110005
6 · The paper itself

Abstract

objectivesThe scarcity of intensive care unit (ICU) beds during the COVID-19 pandemic has led to a large number of national and international guidelines for the triage of ICU admission. Regional variation in medical decision making might affect ICU triage decisions. We investigate whether regional differences in ICU admission, as surrogate for triage decisions, affect in-hospital mortality in COVID-19 patients.

methodsThe COMET study is a multicenter, observational cohort study, including adult patients hospitalized for COVID-19 between March 2020- July 2020. Patients' characteristics, prescribed medication, clinical characteristics, and CFS were collected. Patients from 11 European countries were included and these countries were categorized into two regions: north and south. The effects of region on ICU admission and in-hospital mortality were assessed using logistic regression analyses stratified for frailty.

resultsFrail patients had a higher risk for ICU admission in southern compared to northern countries (OR: 1.64; 95%CI: 1.10-2.46), whereas fit patients had a similar risk for ICU admission in southern compared to northern countries (OR: 0.75; 95%CI: 0.55-1.01). There was no difference in in-hospital mortality between northern and southern countries for fit and frail patients (respectively OR: 0.82; 95% CI 0.52-1.29, and OR: 1.11; 95% CI: 0.74-1.66).

conclusionOur study shows that, despite variation in rates of ICU admission between northern and southern countries for frail patients, no difference in in-hospital mortality was observed. This might help optimize prioritization of resources in a pandemic setting while offering options for palliative care instead of ICU admission.

Indexed as

COVID-19FrailtyHospital MortalityTriageAgedAged, 80 and overCohort StudiesEuropeFemaleHospitalizationHumansIntensive Care UnitsMaleMiddle AgedSARS-CoV-2COVID-19FrailtyPolicyTriage

Identifiers

PMID39905298
PMCPMC11795989

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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.