Erfahrungen aus der SARS-CoV-2-Pandemie am UKSH in Lübeck
摘要
Transfer of critically ill, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients to a tertiary care center in combination with mortality prediction using the Simplified Acute Physiology Score (SAPS II) score has not been investigated in detail so far, in Germany.
Materials and methodsA retrospective analysis of SARS-CoV-2 patients receiving intensive care unit (ICU) treatment at a tertiary care center between 1 March 2020 and 31 December 2021 was performed. Patients directly admitted through the emergency room (PA) and patients admitted later-on from hospitals with lower level of care (SA) were compared.
ResultsIn all, 165 SARS-CoV-2 patients with a SAPS II score received intensive care during the period described. SA patients were significantly younger (SA 62.2 years [IQR 51.9–72.4] vs. PA 70.8 years [IQR 58.3–79.9], p = 0.002), were ventilated longer (SA 16.5 days [IQR 7–31] vs. PA 7 days [IQR 4–11], p < 0.001) but had the same hospital mortality (SA 53.3% vs. PA 45.7%, p = 0.41). Predicted mortality through SAPS II score underestimated true mortality in both patient collectives (SA 15.2% [IQR 7.9–26.6] vs. PA 19.6% [IQR 9.2–34.7], p = 0.17).
ConclusionThe prognostic value of SAPS II is limited for patients suffering from SARS-CoV‑2. Interhospital transfer of critically ill patients seems reasonable since mortality is not different between patients primarily admitted to a tertiary center and patients admitted later-on during disease course.