· A burgeoning body of research exists about factors associated with in-hospital mortality among COVID-19 patients; however, focus on intensive care settings remains limited.
· The most frequent predictors of critical care mortality integrate age, physiologic markers and laboratory parameters in the most parsimonious models or prognostic scoring systems.
· Commonly used prognostic scoring systems such as MEWS, APACHE and SOFA provide crude mortality risk prediction that may be improved with machine learning algorithms that potentially offer more clinically relevant windows and opportunities for mortality risk prediction prior to deterioration.
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· Between centre variation is potentially an important determinant of critical care mortality that needs to be explored.
Williams-Roberts, H; Valiani, S; McLean, M; Miller, L; Howell-Spooner, B. What are the predictors of mortality in hospitalized COVID-19 patients? 2020 Dec 9; Document no.: CC120402 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 33 p. (CEST rapid review report)
There is limited research examining COVID-19 ICU patients undergoing prolonged (>14 days) mechanical ventilation
Rates of prolonged mechanical ventilation, defined as > 14 days, among COVID-19 ICU patients ranged from 16.7% to 33.3%.
Overall, studies suggest that length of ICU stay range from 11 to 31 days and length of hospital stay range from 25 to 51 days among COVID-19 patients who have undergone prolonged mechanical ventilation.
Following ICU discharge, patients are admitted to general wards, subacute nursing facilities, pneumological sub-intensive units, rehabilitation wards or long-term acute care.
Groot, G; McLean, M; Fox, L; Mueller, M. What is the final disposition of post-COVID patients who require chronic ventilation in the ICU? 2021 Feb 27; Document no.: CC011101 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 37 p. (CEST rapid review report)
· Tele-ICU services are provided either by existing staff within the network to smaller centers, or outsourced to larger networks or independent firms
· The impact of tele-ICU adoption can result in a decrease in ICU mortality as large as 32%
· The impact of tele-ICU adoption of length of stay is mixed, with some studies reporting a significant decrease, while others report a small, but statistically insignificant decrease
· The degree of impact of tele-ICU adoption is linked to several factors such as yearly admission rates, location (urban vs. rural) and level of authority given to the tele-ICU team leading to increased positive impacts.
Badea, A; Groot, G; Reeder, B; Young, C; Ellsworth, C; Howell-Spooner, B. How to deliver remote ICU care for COVID-19 patients to avoid/prevent transfer from smaller communities to tertiary care hospitals. 2021 Apr 6; Document no.: CC210301 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 13p. (CEST rapid review report)