Covid-19 patients in one NHS intensive care unit ‘four times more likely to die’, finds University of Cambridge study
Covid-19 patients in one NHS intensive care unit were more than four times as likely to die in a given time period as those in average health trust’s ICU, University of Cambridge researchers have found.
They are calling for urgent research into the causes of disparities in coronavirus mortality rates between NHS trusts to help plan the response should there be further outbreaks.
Using data science techniques, the team - led by Professor Mihaela van der Schaar and intensive care consultant Dr Ari Ercole of the Cambridge Centre for AI in Medicine (CCAIM) - found that the NHS intensive care unit where a Covid-19 patient was treated was as important to their survival chances as known risk factors, such as older age, immunosuppression or chronic heart/kidney disease.
Dr Ercole said: “Covid-19 has stretched most ICUs well beyond their normal capacity and necessitated them finding additional space, equipment and skilled staff – in an already stretched NHS – to deal with demand for highly specialist life-supporting therapies.
“It is possible that some hospitals found this harder either because they didn’t have time to react or the necessary resources.
“It is crucial to understand the reasons for these between-centre differences as we plan our response to similar situations in the future: how and where to build capacity, and how to use what we have most effectively.”
In the worst case, Covid-19 patients treated at one trust’s ICU, which has not been identified, were more than four times as likely to die in a given time period than an average trust.
The analysis covered February 8 to May 22, a period in which there were 5,062 ICU cases in 94 NHS trusts across England, with 1,547 patient deaths and 1,618 discharges from ICU.
The data was anonymised in terms of both patients and NHS trusts. It was derived from the Covid-19 Hospitalisation in England Surveillance System (CHESS) dataset, supplied by Public Health England.
In their peer-reviewed paper, the researchers called for urgent “comparative effectiveness research” to understand the striking differences between NHS trusts, which could help improve practices for surges in Covid-19 in England, and potentially further afield.
The study is the first to reveal the extent to which the patient’s ICU location is a factor in the risk of death.