Comparison of SARS-CoV-2 related in-hospital mortality, ICU admission and mechanical ventilation of 1.4 million patients in Germany and Switzerland, 2019 to 2022.

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES Infection Pub Date : 2024-10-17 DOI:10.1007/s15010-024-02412-9

Cathrin Kodde, Sven Hohenstein, Irit Nachtigall, Yvonne Cavalli, Reto Schuepbach, Raphael Graf, Andreas Bollmann, Ralf Kuhlen

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Abstract

Purpose: In the 2020 emergence of SARS-CoV-2, global response lacked unified treatment and surveillance, resulting in diverse impacts due to varied healthcare resources and national guidelines. Germany and Switzerland curbed the virus initially by promptly tracking and testing, bolstered by strong governmental capacity. This study aimed to assess country-specific healthcare disparities and their impact on ICU admission rates, mechanical ventilation, and in-hospital mortality.

Methods: To enhance healthcare quality using real-world data, the "Initiative of Quality Medicine" (IQM) was established. Pseudonymised routine data from participating hospitals, during 01/01/2019-31/12/2022, was retrospectively analysed, focusing on patients with SARI ± SARS-CoV-2-infection (U07.1). Cohorts were matched based on various factors and multivariable analyses included logistic regression.

Results: 1.421.922 cases of SARI ± U07.1 involving 386 German and 41 Swiss hospitals were included. Patients in Germany were older (mean: 69.4 vs. 66.5 years) and had more comorbidities than in Switzerland (p < .001). Patients in Germany were also more likely to be treated on ICU (28% vs. 20%, OR 1.5 95% CI 1.5-1.6, p < .001) and mechanically ventilated (20% vs. 15%, OR 1.4, 95% CI 1.4-1.5, p < .001). The in-hospital mortality was significantly higher in Germany than in Switzerland (21% vs. 12%, OR 2.0, 95% CI 1.9-2.0, p < .001). Matched cohorts showed reduced differences, but Germany still exhibited higher in-hospital mortality. Discrepancies were evident in both pre-pandemic and pandemic analyses, highlighting existing disparities between both countries.

Conclusion: IQM data from Swiss and German hospitals reveals country-specific differences in SARI ± U07.1 outcomes, highlighting higher in-hospital mortality in Germany, with uncertain causes suggesting varied treatments and resources.

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2019 年至 2022 年德国和瑞士 140 万名患者与 SARS-CoV-2 相关的院内死亡率、重症监护室入院率和机械通气率的比较。

目的：在 2020 年 SARS-CoV-2 出现时，全球缺乏统一的治疗和监控措施，由于医疗资源和国家指导方针的不同，造成了不同的影响。德国和瑞士凭借强大的政府能力，通过及时追踪和检测，初步遏制了病毒的传播。本研究旨在评估各国的医疗保健差异及其对重症监护室入院率、机械通气和院内死亡率的影响：为了利用真实世界的数据提高医疗质量，建立了 "优质医疗倡议"（IQM）。对参与医院在 2019 年 1 月 1 日至 2022 年 12 月 31 日期间的化名常规数据进行了回顾性分析，重点关注 SARI ± SARS-CoV-2 感染（U07.1）患者。根据各种因素对组群进行匹配，并进行逻辑回归等多变量分析：结果：共纳入 1,421,922 例 SARI ± U07.1 病例，涉及 386 家德国医院和 41 家瑞士医院。与瑞士相比，德国的患者年龄更大（平均 69.4 岁，瑞士为 66.5 岁），合并症更多（p 结论：瑞士和德国医院的 IQM 数据显示，瑞士的患者年龄更大，合并症更多：来自瑞士和德国医院的 IQM 数据揭示了 SARI ± U07.1 结果的国家差异，突出显示德国的院内死亡率较高，原因不明，表明治疗方法和资源各不相同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.