ICU Bed Utilization During the Coronavirus Disease 2019 Pandemic in a Multistate Analysis—March to June 2020
Objectives:. Given finite ICU bed capacity, knowledge of ICU bed utilization during the coronavirus disease 2019 pandemic is critical to ensure future strategies for resource allocation and utilization. We sought to examine ICU census trends in relation to ICU bed capacity during the rapid increase...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2021-03-01
|
| Series: | Critical Care Explorations |
| Online Access: | http://journals.lww.com/10.1097/CCE.0000000000000361 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850229601318469632 |
|---|---|
| author | David J. Douin, MD Michael J. Ward, MD, PhD Christopher J. Lindsell, PhD Michelle P. Howell, BSN Catherine L. Hough, MD, MSc Matthew C. Exline, MD Michelle N. Gong, MD Michael S. Aboodi, MD Mark W. Tenforde, MD, PhD Leora R. Feldstein, PhD William B. Stubblefield, MD Jay S. Steingrub, MD Matthew E. Prekker, MD, MPH Samuel M. Brown, MD Ithan D. Peltan, MD, MSc Akram Khan, MD D. Clark Files, MD Kevin W. Gibbs, MD Todd W. Rice, MD, MSc Jonathan D. Casey, MD David N. Hager, MD, PhD Nida Qadir, MD Daniel J. Henning, MD Jennifer G. Wilson, MD, MS Manish M. Patel, MD Wesley H. Self, MD, MPH Adit A. Ginde, MD, MPH |
| author_facet | David J. Douin, MD Michael J. Ward, MD, PhD Christopher J. Lindsell, PhD Michelle P. Howell, BSN Catherine L. Hough, MD, MSc Matthew C. Exline, MD Michelle N. Gong, MD Michael S. Aboodi, MD Mark W. Tenforde, MD, PhD Leora R. Feldstein, PhD William B. Stubblefield, MD Jay S. Steingrub, MD Matthew E. Prekker, MD, MPH Samuel M. Brown, MD Ithan D. Peltan, MD, MSc Akram Khan, MD D. Clark Files, MD Kevin W. Gibbs, MD Todd W. Rice, MD, MSc Jonathan D. Casey, MD David N. Hager, MD, PhD Nida Qadir, MD Daniel J. Henning, MD Jennifer G. Wilson, MD, MS Manish M. Patel, MD Wesley H. Self, MD, MPH Adit A. Ginde, MD, MPH |
| author_sort | David J. Douin, MD |
| collection | DOAJ |
| description | Objectives:. Given finite ICU bed capacity, knowledge of ICU bed utilization during the coronavirus disease 2019 pandemic is critical to ensure future strategies for resource allocation and utilization. We sought to examine ICU census trends in relation to ICU bed capacity during the rapid increase in severe coronavirus disease 2019 cases early during the pandemic.
Design:. Observational cohort study.
Setting:. Thirteen geographically dispersed academic medical centers in the United States.
Patients/Subjects:. We obtained daily ICU censuses from March 26 to June 30, 2020, as well as prepandemic ICU bed capacities. The primary outcome was daily census of ICU patients stratified by coronavirus disease 2019 and mechanical ventilation status in relation to ICU capacity.
Interventions:. None.
Measurements and Main Results:. Prepandemic overall ICU capacity ranged from 62 to 225 beds (median 109). During the study period, the median daily coronavirus disease 2019 ICU census per hospital ranged from 1 to 84 patients, and the daily ICU census exceeded overall ICU capacity for at least 1 day at five institutions. The number of critically ill patients exceeded ICU capacity for a median (interquartile range) of 17 (12–50) of 97 days at these five sites. All 13 institutions experienced decreases in their noncoronavirus disease ICU population, whereas local coronavirus disease 2019 cases increased. Coronavirus disease 2019 patients reached their greatest proportion of ICU capacity on April 12, 2020, when they accounted for 44% of ICU patients across all participating hospitals. Maximum ICU census ranged from 52% to 289% of overall ICU capacity, with three sites less than 80%, four sites 80–100%, five sites 100–128%, and one site 289%.
Conclusions:. From March to June 2020, the coronavirus disease 2019 pandemic led to ICU censuses greater than ICU bed capacity at fives of 13 institutions evaluated. These findings demonstrate the short-term adaptability of U.S. healthcare institutions in redirecting limited resources to accommodate a public health emergency. |
| format | Article |
| id | doaj-art-bf8ae6c00d02432fa286bbb01b37959c |
| institution | OA Journals |
| issn | 2639-8028 |
| language | English |
| publishDate | 2021-03-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Critical Care Explorations |
| spelling | doaj-art-bf8ae6c00d02432fa286bbb01b37959c2025-08-20T02:04:09ZengWolters KluwerCritical Care Explorations2639-80282021-03-0133e036110.1097/CCE.0000000000000361202103000-00014ICU Bed Utilization During the Coronavirus Disease 2019 Pandemic in a Multistate Analysis—March to June 2020David J. Douin, MD0Michael J. Ward, MD, PhD1Christopher J. Lindsell, PhD2Michelle P. Howell, BSN3Catherine L. Hough, MD, MSc4Matthew C. Exline, MD5Michelle N. Gong, MD6Michael S. Aboodi, MD7Mark W. Tenforde, MD, PhD8Leora R. Feldstein, PhD9William B. Stubblefield, MD10Jay S. Steingrub, MD11Matthew E. Prekker, MD, MPH12Samuel M. Brown, MD13Ithan D. Peltan, MD, MSc14Akram Khan, MD15D. Clark Files, MD16Kevin W. Gibbs, MD17Todd W. Rice, MD, MSc18Jonathan D. Casey, MD19David N. Hager, MD, PhD20Nida Qadir, MD21Daniel J. Henning, MD22Jennifer G. Wilson, MD, MS23Manish M. Patel, MD24Wesley H. Self, MD, MPH25Adit A. Ginde, MD, MPH261 University of Colorado School of Medicine, Aurora, CO.2 Vanderbilt University Medical Center, Nashville, TN.2 Vanderbilt University Medical Center, Nashville, TN.1 University of Colorado School of Medicine, Aurora, CO.3 Oregon Health & Science University School of Medicine, Portland, OR.4 Ohio State University, Wexner Medical Center, Columbus, OH.5 Albert Einstein College of Medicine, Bronx, NY.5 Albert Einstein College of Medicine, Bronx, NY.6 CDC COVID-19 Response Team, Atlanta, GA.6 CDC COVID-19 Response Team, Atlanta, GA.2 Vanderbilt University Medical Center, Nashville, TN.7 Baystate Medical Center, Springfield, MA.8 Hennepin County Medical Center, Minneapolis, MN.9 Intermountain Medical Center and University of Utah School of Medicine, Salt Lake City, UT.9 Intermountain Medical Center and University of Utah School of Medicine, Salt Lake City, UT.3 Oregon Health & Science University School of Medicine, Portland, OR.10 Wake Forest University Baptist Medical Center, Winston-Salem, NC.10 Wake Forest University Baptist Medical Center, Winston-Salem, NC.2 Vanderbilt University Medical Center, Nashville, TN.2 Vanderbilt University Medical Center, Nashville, TN.11 Johns Hopkins Hospital, Baltimore, MD.12 David Geffen School of Medicine at UCLA, Los Angeles, CA.13 Harborview Medical Center, Seattle, WA.14 Stanford Hospital Medical Center, Palo Alto, CA.6 CDC COVID-19 Response Team, Atlanta, GA.2 Vanderbilt University Medical Center, Nashville, TN.1 University of Colorado School of Medicine, Aurora, CO.Objectives:. Given finite ICU bed capacity, knowledge of ICU bed utilization during the coronavirus disease 2019 pandemic is critical to ensure future strategies for resource allocation and utilization. We sought to examine ICU census trends in relation to ICU bed capacity during the rapid increase in severe coronavirus disease 2019 cases early during the pandemic. Design:. Observational cohort study. Setting:. Thirteen geographically dispersed academic medical centers in the United States. Patients/Subjects:. We obtained daily ICU censuses from March 26 to June 30, 2020, as well as prepandemic ICU bed capacities. The primary outcome was daily census of ICU patients stratified by coronavirus disease 2019 and mechanical ventilation status in relation to ICU capacity. Interventions:. None. Measurements and Main Results:. Prepandemic overall ICU capacity ranged from 62 to 225 beds (median 109). During the study period, the median daily coronavirus disease 2019 ICU census per hospital ranged from 1 to 84 patients, and the daily ICU census exceeded overall ICU capacity for at least 1 day at five institutions. The number of critically ill patients exceeded ICU capacity for a median (interquartile range) of 17 (12–50) of 97 days at these five sites. All 13 institutions experienced decreases in their noncoronavirus disease ICU population, whereas local coronavirus disease 2019 cases increased. Coronavirus disease 2019 patients reached their greatest proportion of ICU capacity on April 12, 2020, when they accounted for 44% of ICU patients across all participating hospitals. Maximum ICU census ranged from 52% to 289% of overall ICU capacity, with three sites less than 80%, four sites 80–100%, five sites 100–128%, and one site 289%. Conclusions:. From March to June 2020, the coronavirus disease 2019 pandemic led to ICU censuses greater than ICU bed capacity at fives of 13 institutions evaluated. These findings demonstrate the short-term adaptability of U.S. healthcare institutions in redirecting limited resources to accommodate a public health emergency.http://journals.lww.com/10.1097/CCE.0000000000000361 |
| spellingShingle | David J. Douin, MD Michael J. Ward, MD, PhD Christopher J. Lindsell, PhD Michelle P. Howell, BSN Catherine L. Hough, MD, MSc Matthew C. Exline, MD Michelle N. Gong, MD Michael S. Aboodi, MD Mark W. Tenforde, MD, PhD Leora R. Feldstein, PhD William B. Stubblefield, MD Jay S. Steingrub, MD Matthew E. Prekker, MD, MPH Samuel M. Brown, MD Ithan D. Peltan, MD, MSc Akram Khan, MD D. Clark Files, MD Kevin W. Gibbs, MD Todd W. Rice, MD, MSc Jonathan D. Casey, MD David N. Hager, MD, PhD Nida Qadir, MD Daniel J. Henning, MD Jennifer G. Wilson, MD, MS Manish M. Patel, MD Wesley H. Self, MD, MPH Adit A. Ginde, MD, MPH ICU Bed Utilization During the Coronavirus Disease 2019 Pandemic in a Multistate Analysis—March to June 2020 Critical Care Explorations |
| title | ICU Bed Utilization During the Coronavirus Disease 2019 Pandemic in a Multistate Analysis—March to June 2020 |
| title_full | ICU Bed Utilization During the Coronavirus Disease 2019 Pandemic in a Multistate Analysis—March to June 2020 |
| title_fullStr | ICU Bed Utilization During the Coronavirus Disease 2019 Pandemic in a Multistate Analysis—March to June 2020 |
| title_full_unstemmed | ICU Bed Utilization During the Coronavirus Disease 2019 Pandemic in a Multistate Analysis—March to June 2020 |
| title_short | ICU Bed Utilization During the Coronavirus Disease 2019 Pandemic in a Multistate Analysis—March to June 2020 |
| title_sort | icu bed utilization during the coronavirus disease 2019 pandemic in a multistate analysis march to june 2020 |
| url | http://journals.lww.com/10.1097/CCE.0000000000000361 |
| work_keys_str_mv | AT davidjdouinmd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT michaeljwardmdphd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT christopherjlindsellphd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT michellephowellbsn icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT catherinelhoughmdmsc icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT matthewcexlinemd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT michellengongmd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT michaelsaboodimd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT markwtenfordemdphd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT leorarfeldsteinphd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT williambstubblefieldmd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT jayssteingrubmd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT mattheweprekkermdmph icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT samuelmbrownmd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT ithandpeltanmdmsc icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT akramkhanmd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT dclarkfilesmd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT kevinwgibbsmd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT toddwricemdmsc icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT jonathandcaseymd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT davidnhagermdphd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT nidaqadirmd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT danieljhenningmd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT jennifergwilsonmdms icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT manishmpatelmd icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT wesleyhselfmdmph icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 AT aditagindemdmph icubedutilizationduringthecoronavirusdisease2019pandemicinamultistateanalysismarchtojune2020 |