Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Effectiveness of Intermediate Respiratory Care Units as An Alternative to Intensive Care Units During The Covid-19 Pandemic in Catalonia

Version 1 : Received: 11 April 2022 / Approved: 12 April 2022 / Online: 12 April 2022 (08:49:09 CEST)

A peer-reviewed article of this Preprint also exists.

Galdeano Lozano, M.; Alfaro Álvarez, J.C.; Parra Macías, N.; Salas Campos, R.; Heili Frades, S.; Montserrat, J.M.; Rosell Gratacós, A.; Abad Capa, J.; Parra Ordaz, O.; López Seguí, F. Effectiveness of Intermediate Respiratory Care Units as an Alternative to Intensive Care Units during the COVID-19 Pandemic in Catalonia. Int. J. Environ. Res. Public Health 2022, 19, 6034. Galdeano Lozano, M.; Alfaro Álvarez, J.C.; Parra Macías, N.; Salas Campos, R.; Heili Frades, S.; Montserrat, J.M.; Rosell Gratacós, A.; Abad Capa, J.; Parra Ordaz, O.; López Seguí, F. Effectiveness of Intermediate Respiratory Care Units as an Alternative to Intensive Care Units during the COVID-19 Pandemic in Catalonia. Int. J. Environ. Res. Public Health 2022, 19, 6034.

Journal reference: Int. J. Environ. Res. Public Health 2022, 19, 6034
DOI: 10.3390/ijerph19106034

Abstract

OBJETIVES: During the COVID-19 pandemic, the risk of collapse of the health system created great difficulties. We will demonstrate that Intermediate Respiratory Care Units (IRCU) provide adequate management of patients with non-invasive respiratory support, which is particularly important in patients with SARS-CoV-2 pneumonia. METHODS: A prospective observational study of patients with COVID-19 admitted to the ICU of a tertiary hospital. Sociodemographic data, comorbidities, pharmacological, respiratory support, laboratory and blood gas variables were collected. The overall cost of the unit was subsequently analyzed. RESULTS: 991 patients were admitted, 56 to the IRCU (of the 81 a critical care unit). Mean age was 65 years (SD 12.8), Barthel Index 75 (SD 8.3), Charlson 3.1 (SD 2.2), HTN 27%, COPD 89% and obesity 24%. Significant relationship (p <0.05) with higher mortality of the following: fever greater than or equal to 39oC [OR 5.6; 95% CI (1.2-2.7); p = 0.020], protocolized pharmacological treatment [OR 0.3; 95% CI (0.1-0.9); p = 0.023] and IOI [OR 3.7; 95% CI (1.1-12.3); p = 0.025]. NIMV showed less of a negative impact [OR 1.8; 95% CI (0.4-8.4); p = 0.423] than IOI. The total cost of the IRCUs amounted to €66,233. The cost per day of stay in the IRCU was €164 per patient. The total cost avoided was €214,865. CONCLUSION: The pandemic has highlighted the importance of IRCUs in facilitating the management of a high patient volume. The treatment carried out in IRCUs is effective and efficient, reducing both admissions to and stays in the ICU.

Keywords

respiratory care; covid; ICU; cost-effectiveness

Subject

LIFE SCIENCES, Virology

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