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Hospital cohort study on survival predictors for intubated coronavirus disease 2019 patients

Fabiola Jahn Deschamps1,2, Paulo Sergio da Silva Deschamps1,2,3, Laura Correa da Silva2

  • 1Centro Universitário Faculdade de Medicina do ABC, Graduate Program in Health Sciences - Santo Andre (SP), Brazil.

Revista Da Associacao Medica Brasileira (1992)
|May 22, 2024
PubMed

Insights

Predictors of survival in intubated coronavirus disease 2019 patients were analyzed. Emergency physician-led intubation significantly increased mortality risk compared to anesthesiologists, highlighting the importance of team expertise in critical care.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Epidemiology

Background:

  • Coronavirus disease 2019 (COVID-19) necessitated advanced respiratory support, including tracheal intubation.
  • Predicting survival in critically ill COVID-19 patients undergoing intubation is crucial for resource allocation and patient management.

Purpose of the Study:

  • To identify predictors of 90-day survival in adult patients with COVID-19 who underwent tracheal intubation.
  • To evaluate the impact of various factors, including the medical professional performing the intubation, on patient outcomes.

Main Methods:

  • A retrospective cohort study was conducted at Rio do Sul County Hospital, Brazil, between April 2020 and May 2021.
  • Data from 132 adult patients intubated for COVID-19 were analyzed using Cox proportional hazards regression to estimate hazard ratios for 90-day mortality.

Main Results:

  • The overall 90-day mortality rate was 62.9%.
  • Predictors of increased mortality included age over 60 years, pre-intubation blood oxygen saturation below 85%, use of a conventional laryngoscope, and intubation performed by emergency physicians.
  • Intubation by emergency physicians was associated with a nearly fourfold increase in mortality risk (Hazard Ratio=3.96).

Conclusions:

  • The medical professional leading tracheal intubation significantly impacts survival outcomes in COVID-19 patients.
  • Anesthesiologist-led intubation teams appear to be associated with better survival rates compared to those led by emergency physicians.
  • These findings underscore the need for specialized expertise in airway management for critically ill COVID-19 patients.
Abstract

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