Show simple item record

Files in this item

Thumbnail

Item metadata

dc.contributor.authorKrishnan, Jamuna K.
dc.contributor.authorRajan, Mangala
dc.contributor.authorBaer, Benjamin R
dc.contributor.authorHoffman, Katherine L.
dc.contributor.authorAlshak, Mark N.
dc.contributor.authorAronson, Kerri I.
dc.contributor.authorGoyal, Parag
dc.contributor.authorEzeomah, Chiomah
dc.contributor.authorHill, Shanna S.
dc.contributor.authorMartinez, Fernando J.
dc.contributor.authorTuretz, Meredith L.
dc.contributor.authorWell, Martin T.
dc.contributor.authorSafford, Monika M.
dc.contributor.authorSchenck, Edward J.
dc.date.accessioned2024-04-02T15:30:06Z
dc.date.available2024-04-02T15:30:06Z
dc.date.issued2022-08
dc.identifier293971128
dc.identifier33e8db5f-e26a-45ae-b16d-f16320e94f7a
dc.identifier85129926674
dc.identifier.citationKrishnan , 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.2022.154045en
dc.identifier.otherBibtex: krishnan2021mortality
dc.identifier.urihttps://hdl.handle.net/10023/29586
dc.descriptionFunding: Dr. Krishnan reports support from NIH T32 HL134629. Dr. Schenck reports support from NHLBI K23 HL151876.en
dc.description.abstractPurpose 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.extent8
dc.format.extent532599
dc.language.isoeng
dc.relation.ispartofJournal of Critical Careen
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.subject3rd-DASen
dc.subjectACen
dc.subject.lccRA0421en
dc.titleAssessing mortality differences across acute respiratory failure management strategies in Covid-19en
dc.typeJournal articleen
dc.contributor.institutionUniversity of St Andrews. Statisticsen
dc.identifier.doi10.1016/j.jcrc.2022.154045
dc.description.statusPeer revieweden
dc.date.embargoedUntil2023-04-28
dc.identifier.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9049881/en


This item appears in the following Collection(s)

Show simple item record