Observational studyCritical care (London, England)2025
The impact of intensive care strain on patients' outcomes-a multinational observational cohort (UNITE-COVID) study.
Observational study in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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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.
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.
Who cites it
5 citing papers in PubMed.
- Incidence and Associated Factors for Chronic Pain After ICU Discharge: A Prospective Study.Nursing in critical care · 2026Article
- From the ICU Bedside: Applying the Transnational Clinical Academic Doctorate Lens to a Clinically Embedded PhD Journey.Journal of advanced nursing · 2026Review
- COVID-19 Mortality in Swedish Intensive Care Units: A Multicenter Survival Analysis.Acta anaesthesiologica Scandinavica · 2026Article
- Construction and validation of a prognostic model for in-hospital multiple organ dysfunction syndrome in ICU patients with respiratory failure based on ultrasound and laboratory parameters.Journal of thoracic disease · 2026Article
- EU preparedness and ICU capacity: where are the beds?Intensive care medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
purposeIntensive care unit (ICU) strain is associated with increased mortality. Most strain metrics focus on 'simple' measures such as bed occupancy or admission rates. There is limited data on mitigation strategies, such as procedure teams or staff well-being services on strain, or the impact of increased patient-to-nurse ratios and non-ICU trained nurses working in ICU.
methodsUsing the multi-national UNITE-COVID study, collecting data from ICUs on their day of peak bed occupancy in two periods (2020 and 2021) of the COVID-19 pandemic, we evaluated metrics of strain (Bed occupancy, patient: nurse ratio, use of non-ICU staff and shortages of consumables) and potential mitigators (procedural support teams and staff well-being interventions). We examined how these related to outcomes (mortality, complications, length of stay).
resultsIn both epochs, ICUs experienced significant strain, with ICU bed expansion to 133% and 163% respectively, whilst patient-to-nurse ratios increased by 0.4 and 0.3. Consumable shortages were widespread in 2020. Mortality was inversely correlated with staff well-being interventions in both epochs. Complications were inversely correlated with procedure support teams, and positively correlated with staffing ratios. In regression models, pressure sores were reduced in presence of support teams (p = 0.004) and increased with increasing patients per nurse (p = 0.05) whilst unplanned extubations were related to non-ICU trained staff working in ICU(p = 0.02).
conclusionsCOVID-19 induced ICU strain had effects beyond mortality, including increases in complications. Staff pressure and lack of ICU training were related to specific complications, whilst support teams and well-being interventions were associated with improved outcomes.
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Registered trials
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.