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1000 Titel
  • Joint analysis of duration of ventilation, length of intensive care, and mortality of COVID-19 patients: a multistate approach
1000 Autor/in
  1. Hazard, Derek |
  2. Kaier, Klaus |
  3. von Cube, Maja |
  4. Grodd, Marlon |
  5. Bugiera, Lars |
  6. Lambert, Jerome |
  7. Wolkewitz, Martin |
1000 Erscheinungsjahr 2020
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2020-08-11
1000 Erschienen in
1000 Quellenangabe
  • 20(1):206
1000 FRL-Sammlung
1000 Copyrightjahr
  • 2020
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s12874-020-01082-z |
1000 Ergänzendes Material
  • https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-020-01082-z#Sec13 |
1000 Publikationsstatus
1000 Begutachtungsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • BACKGROUND: The clinical progress of patients hospitalized due to COVID-19 is often associated with severe pneumonia which may require intensive care, invasive ventilation, or extracorporeal membrane oxygenation (ECMO). The length of intensive care and the duration of these supportive therapies are clinically relevant outcomes. From the statistical perspective, these quantities are challenging to estimate due to episodes being time-dependent and potentially multiple, as well as being determined by the competing, terminal events of discharge alive and death. METHODS: We used multistate models to study COVID-19 patients’ time-dependent progress and provide a statistical framework to estimate hazard rates and transition probabilities. These estimates can then be used to quantify average sojourn times of clinically important states such as intensive care and invasive ventilation. We have made two real data sets of COVID-19 patients (n = 24* and n = 53**) and the corresponding statistical code publically available. RESULTS: The expected lengths of intensive care unit (ICU) stay at day 28 for the two cohorts were 15.05* and 19.62** days, while expected durations of mechanical ventilation were 7.97* and 9.85** days. Predicted mortality stood at 51%* and 15%**. Patients mechanically ventilated at the start of the example studies had a longer expected duration of ventilation (12.25*, 14.57** days) compared to patients non-ventilated (4.34*, 1.41** days) after 28 days. Furthermore, initially ventilated patients had a higher risk of death (54%* and 20%** vs. 48%* and 6%**) after 4 weeks. These results are further illustrated in stacked probability plots for the two groups from time zero, as well as for the entire cohort which depicts the predicted proportions of the patients in each state over follow-up. CONCLUSIONS: The multistate approach gives important insights into the progress of COVID-19 patients in terms of ventilation duration, length of ICU stay, and mortality. In addition to avoiding frequent pitfalls in survival analysis, the methodology enables active cases to be analyzed by allowing for censoring. The stacked probability plots provide extensive information in a concise manner that can be easily conveyed to decision makers regarding healthcare capacities. Furthermore, clear comparisons can be made among different baseline characteristics.
1000 Sacherschließung
gnd 1206347392 COVID-19
lokal Competing risks
lokal Length of stay
lokal Multistate model
lokal Mechanical ventilation
lokal SARS-CoV-2
1000 Fächerklassifikation (DDC)
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0001-7874-7567|https://frl.publisso.de/adhoc/uri/S2FpZXIsIEtsYXVz|https://frl.publisso.de/adhoc/uri/dm9uIEN1YmUsIE1hamE=|https://frl.publisso.de/adhoc/uri/R3JvZGQsIE1hcmxvbg==|https://frl.publisso.de/adhoc/uri/QnVnaWVyYSwgTGFycw==|https://frl.publisso.de/adhoc/uri/TGFtYmVydCwgSmVyb21l|https://frl.publisso.de/adhoc/uri/V29sa2V3aXR6LCBNYXJ0aW4=
1000 Label
1000 Förderer
  1. Edmond de Rothschild Foundation |
  2. Projekt DEAL |
1000 Fördernummer
  1. -
  2. -
1000 Förderprogramm
  1. -
  2. -
1000 Dateien
1000 Förderung
  1. 1000 joinedFunding-child
    1000 Förderer Edmond de Rothschild Foundation |
    1000 Förderprogramm -
    1000 Fördernummer -
  2. 1000 joinedFunding-child
    1000 Förderer Projekt DEAL |
    1000 Förderprogramm -
    1000 Fördernummer -
1000 Objektart article
1000 Beschrieben durch
1000 @id frl:6422489.rdf
1000 Erstellt am 2020-08-12T09:03:06.960+0200
1000 Erstellt von 122
1000 beschreibt frl:6422489
1000 Bearbeitet von 25
1000 Zuletzt bearbeitet 2021-09-28T14:13:53.180+0200
1000 Objekt bearb. Tue Sep 28 14:13:52 CEST 2021
1000 Vgl. frl:6422489
1000 Oai Id
  1. oai:frl.publisso.de:frl:6422489 |
1000 Sichtbarkeit Metadaten public
1000 Sichtbarkeit Daten public
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