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Assessing mortality differences across acute respiratory failure management strategies in Covid-19
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dc.contributor.author | Krishnan, Jamuna K. | |
dc.contributor.author | Rajan, Mangala | |
dc.contributor.author | Baer, Benjamin R | |
dc.contributor.author | Hoffman, Katherine L. | |
dc.contributor.author | Alshak, Mark N. | |
dc.contributor.author | Aronson, Kerri I. | |
dc.contributor.author | Goyal, Parag | |
dc.contributor.author | Ezeomah, Chiomah | |
dc.contributor.author | Hill, Shanna S. | |
dc.contributor.author | Martinez, Fernando J. | |
dc.contributor.author | Turetz, Meredith L. | |
dc.contributor.author | Well, Martin T. | |
dc.contributor.author | Safford, Monika M. | |
dc.contributor.author | Schenck, Edward J. | |
dc.date.accessioned | 2024-04-02T15:30:06Z | |
dc.date.available | 2024-04-02T15:30:06Z | |
dc.date.issued | 2022-08 | |
dc.identifier | 293971128 | |
dc.identifier | 33e8db5f-e26a-45ae-b16d-f16320e94f7a | |
dc.identifier | 85129926674 | |
dc.identifier.citation | Krishnan , J K , Rajan , M , Baer , B R , Hoffman , K L , Alshak , M N , Aronson , K I , Goyal , P , Ezeomah , C , Hill , S S , Martinez , F J , Turetz , M L , Well , M T , Safford , M M & Schenck , E J 2022 , ' Assessing mortality differences across acute respiratory failure management strategies in Covid-19 ' , Journal of Critical Care , vol. 70 , 154045 . https://doi.org/10.1016/j.jcrc.2022.154045 | en |
dc.identifier.other | Bibtex: krishnan2021mortality | |
dc.identifier.uri | https://hdl.handle.net/10023/29586 | |
dc.description | Funding: Dr. Krishnan reports support from NIH T32 HL134629. Dr. Schenck reports support from NHLBI K23 HL151876. | en |
dc.description.abstract | Purpose Prolonged observation could avoid invasive mechanical ventilation (IMV) and related risks in patients with Covid-19 acute respiratory failure (ARF) compared to initiating early IMV. We aimed to determine the association between ARF management strategy and in-hospital mortality. Materials and methods Patients in the Weill Cornell Covid-19 registry who developed ARF between March 5 – March 25, 2020 were exposed to an early IMV strategy; between March 26 – April 1, 2020 to an intermediate strategy; and after April 2 to prolonged observation. Cox proportional hazards regression was used to model in-hospital mortality and test an interaction between ARF management strategy and modified sequential organ failure assessment (mSOFA). Results Among 632 patients with ARF, 24% of patients in the early IMV strategy died versus 28% in prolonged observation. At lower mSOFA, prolonged observation was associated with lower mortality compared to early IMV (at mSOFA = 0, HR 0.16 [95% CI 0.04–0.57]). Mortality risk increased in the prolonged observation strategy group with each point increase in mSOFA score (HR 1.29 [95% CI 1.10–1.51], p = 0.002). Conclusion In Covid-19 ARF, prolonged observation was associated with a mortality benefit at lower mSOFA scores, and increased mortality at higher mSOFA scores compared to early IMV. | |
dc.format.extent | 8 | |
dc.format.extent | 532599 | |
dc.language.iso | eng | |
dc.relation.ispartof | Journal of Critical Care | en |
dc.subject | RA0421 Public health. Hygiene. Preventive Medicine | en |
dc.subject | 3rd-DAS | en |
dc.subject | AC | en |
dc.subject.lcc | RA0421 | en |
dc.title | Assessing mortality differences across acute respiratory failure management strategies in Covid-19 | en |
dc.type | Journal article | en |
dc.contributor.institution | University of St Andrews. Statistics | en |
dc.identifier.doi | 10.1016/j.jcrc.2022.154045 | |
dc.description.status | Peer reviewed | en |
dc.date.embargoedUntil | 2023-04-28 | |
dc.identifier.url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9049881/ | en |
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