Biased and unbiased estimation of the average length of stay in intensive care units in the Covid-19 pandemic.
Biased and unbiased estimation of the average length of stay in intensive care units in the Covid-19 pandemic.
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对 Covid-19 大流行期间重症监护病房平均住院时间的有偏和无偏估计
DOI：
10.1186/s13613-020-00749-6
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发表时间：
2020-10-16
影响因子：
8.1
通讯作者：
Hejblum G
中科院分区：
文献类型：
--
作者：
Lapidus N;Zhou X;Carrat F;Riou B;Zhao Y;Hejblum G
重症监护病房(ICU_ALOS)的平均住院时间(LOS)是总结危重床位占有率的有用参数。在新病毒暴发期间，及早估计感染患者的可靠ICU_ALOS估计对于准确地将检查缓解和准备情景的模型参数化是至关重要的。比较了ICU_ALOS的两种估计方法：估计日期已出院患者的平均LOS(DPE)，以及用于分析事件发生时间数据的标准参数方法，该方法符合观察数据的给定分布，并包括在估计日期(CPE)仍在ICU接受治疗的患者的经审查的停留时间。方法对一系列新冠肺炎患者(n = ，59例)在专门治疗此类患者的ICU中进行比较。在最后一次随访日期，即首次入院后99天，除一名患者外，所有患者均已出院。一项模拟研究考察了这些方法模式的泛化能力。CPE和DPE估计也与迄今报道的新冠肺炎估计进行了比较。LOS ≥ 30天涉及59名患者中的14名(24%)，包括观察到的21例死亡中的8例。首次入院2个月后，38例(%)患者已出院，相应的DPE和CPE估计ICU_ALOS(95%CI)分别为13.0天(10.4~15.6天)和23.1天(18.1~29.7天)。该系列的真实ICU_ALOS超过21天，远高于迄今报道的估计。更有可能在暴发过程中较早地观察到短期停留的排放。谨慎、无偏倚的ICUALOS估计建议将比新冠肺炎预测模型中采用的更高的ICU床位占用负担参数化。国家自然科学基金项目中国(81900097-周博士)和湖北省科技厅应急响应项目(2020FCA023-Pr.赵)。
The average length of stay (LOS) in the intensive care unit (ICU_ALOS) is a helpful parameter summarizing critical bed occupancy. During the outbreak of a novel virus, estimating early a reliable ICU_ALOS estimate of infected patients is critical to accurately parameterize models examining mitigation and preparedness scenarios. Two estimation methods of ICU_ALOS were compared: the average LOS of already discharged patients at the date of estimation (DPE), and a standard parametric method used for analyzing time-to-event data which fits a given distribution to observed data and includes the censored stays of patients still treated in the ICU at the date of estimation (CPE). Methods were compared on a series of all COVID-19 consecutive cases (n = 59) admitted in an ICU devoted to such patients. At the last follow-up date, 99 days after the first admission, all patients but one had been discharged. A simulation study investigated the generalizability of the methods' patterns. CPE and DPE estimates were also compared to COVID-19 estimates reported to date. LOS ≥ 30 days concerned 14 out of the 59 patients (24%), including 8 of the 21 deaths observed. Two months after the first admission, 38 (64%) patients had been discharged, with corresponding DPE and CPE estimates of ICU_ALOS (95% CI) at 13.0 days (10.4–15.6) and 23.1 days (18.1–29.7), respectively. Series' true ICU_ALOS was greater than 21 days, well above reported estimates to date. Discharges of short stays are more likely observed earlier during the course of an outbreak. Cautious unbiased ICU_ALOS estimates suggest parameterizing a higher burden of ICU bed occupancy than that adopted to date in COVID-19 forecasting models. Support by the National Natural Science Foundation of China (81900097 to Dr. Zhou) and the Emergency Response Project of Hubei Science and Technology Department (2020FCA023 to Pr. Zhao).
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DOI：
10.1073/pnas.2004064117
发表时间：
2020-04-21
影响因子：
11.1
作者：
Moghadas, Seyed M.;Shoukat, Affan;Galvani, Alison P.
通讯作者：
Galvani, Alison P.
影响因子：
39.2
作者：
Weissman, Gary E.;Crane-Droesch, Andrew;Halpern, Scott D.
通讯作者：
Halpern, Scott D.
影响因子：
3.8
作者：
Lipsitch M;Donnelly CA;Fraser C;Blake IM;Cori A;Dorigatti I;Ferguson NM;Garske T;Mills HL;Riley S;Van Kerkhove MD;Hernán MA
通讯作者：
Hernán MA
中国武汉市 138 例 2019 新型冠状病毒感染肺炎住院患者的临床特征。
影响因子：
120.7
作者：
Wang, Dawei;Hu, Bo;Peng, Zhiyong
通讯作者：
Peng, Zhiyong
影响因子：
120.7
作者：
Grasselli, Giacomo;Zangrillo, Alberto;Pesenti, Antonio
通讯作者：
Pesenti, Antonio