J. Schüttler, J. Mang, L. Kapsner, S. Seuchter, H. Binder, D. Zoller, O. Kohlbacher, M. Boeker, K. Zacharowski, G. Rohde, J. Balig, M. Kampf, R. Rohrig, H. Prokosch
Background: In the initial phase of the COVID-19 pandemic, a lower incidence and death rate was observed in Germany compared to its neighbouring countries, but some studies showed comparatively high death rates in ventilated COVID-19 patients. Methods: In this retrospective analysis, hospital stays of COVID-19 patients at 14 German university hospitals were analysed. For this purpose, local data integration centres of the German Medical Informatics Initiative (MII) combined their data to present death rates in different subgroups depending on gender, age, length of stay in the intensive care unit, ventilation and in combination with different comorbidities. Results: The total lethality rate in 1,318 COVID-19 patients was 18.8 %. In ventilated cases, the lethality rate was 38.8%. Common comorbidities were renal insufficiency (35.2 %), aplastic and other anaemia (26.0 %) diabetes mellitus (21.1 %). The average length of stay was 18 days, or 28 days in case of ventilated patients. Lethality decreased from 20.7 % to 12.7 % over the observation period. Conclusion: The observed decline in lethality rates may be explained with the continuous optimisation of COVID-19 treatment, increasing experience and improved therapy recommendations. The progress made so far by the MII allows cross-consortium analyses to be carried out just in time to better address the challenges of the COVID-19 pandemic.
{"title":"Studies on COVID-19 lethality: Causes and dynamics at German University Hospitals","authors":"J. Schüttler, J. Mang, L. Kapsner, S. Seuchter, H. Binder, D. Zoller, O. Kohlbacher, M. Boeker, K. Zacharowski, G. Rohde, J. Balig, M. Kampf, R. Rohrig, H. Prokosch","doi":"10.19224/ai2021.244","DOIUrl":"https://doi.org/10.19224/ai2021.244","url":null,"abstract":"Background: In the initial phase of the COVID-19 pandemic, a lower incidence and death rate was observed in Germany compared to its neighbouring countries, but some studies showed comparatively high death rates in ventilated COVID-19 patients. Methods: In this retrospective analysis, hospital stays of COVID-19 patients at 14 German university hospitals were analysed. For this purpose, local data integration centres of the German Medical Informatics Initiative (MII) combined their data to present death rates in different subgroups depending on gender, age, length of stay in the intensive care unit, ventilation and in combination with different comorbidities. Results: The total lethality rate in 1,318 COVID-19 patients was 18.8 %. In ventilated cases, the lethality rate was 38.8%. Common comorbidities were renal insufficiency (35.2 %), aplastic and other anaemia (26.0 %) diabetes mellitus (21.1 %). The average length of stay was 18 days, or 28 days in case of ventilated patients. Lethality decreased from 20.7 % to 12.7 % over the observation period. Conclusion: The observed decline in lethality rates may be explained with the continuous optimisation of COVID-19 treatment, increasing experience and improved therapy recommendations. The progress made so far by the MII allows cross-consortium analyses to be carried out just in time to better address the challenges of the COVID-19 pandemic.","PeriodicalId":55516,"journal":{"name":"Anasthesiologie & Intensivmedizin","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76209879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"New treatment approaches and the dilemma of medical ethics and economics using haemoadsorption with Cytosorb","authors":"T. Datzmann, S. Sausmann, H. Reinelt, K. Träger","doi":"10.19224/AI2021.193","DOIUrl":"https://doi.org/10.19224/AI2021.193","url":null,"abstract":"","PeriodicalId":55516,"journal":{"name":"Anasthesiologie & Intensivmedizin","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86113866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Hiller, K. Spohn, J. Schütte, H. Bracht, Laura Hering, J. Bakker, S. Schröder
Despite the high number of intensive care beds in German hospitals compared to other European countries, intensive care medical shortages are common in daily clinical practice. This is due to a hardly established cross-departmental discharge and transfer management with missing objective discharge criteria, lack of personnel and bed closures. Aboveaverage lengths of stays and increased readmission rates to the intensive care unit also indicate an inefficient use of resources in German hospitals. Against this background, a systematic literature search was carried out on the current state of research on discharge criteria from the intensive care unit and transfer processes to follow-up wards. Between 1983 and 2020, 1,917 sources were found, 286 were selected as full text, 104 of which were considered relevant and used as the basis for this work. Approaches, such as a root cause analy- sis of bottleneck situations including the entire hospital system with its interdependent admission, transfer and discharge processes, and the use of electronic decision support in conjunction with standardised discharge criteria can improve the use of existing intensive care capacities and lead to safer and better patient flow. For better use of resources, the therapeutic outcome must be viewed along the entire clinical pathway in order to care for the right patient at the right place and at the right time. A standardised care transition management using objective discharge criteria could help to include the various stakeholders in the discharge decision and patient-transfer process to reflect patient-, caregiver-, process, and institution-specific factors, and ultimately to manage, proactively and efficiently, the available intensive care resources. Decision support in the discharge process using self-learning systems based on available data from patient data management systems is forward-looking, but must be validated more widely in clinical practice.
{"title":"Objektive Verlegungskriterien und proaktives Verlegungsmanagement zur Steuerung von intensivmedizinischen Kapazitäten","authors":"M. Hiller, K. Spohn, J. Schütte, H. Bracht, Laura Hering, J. Bakker, S. Schröder","doi":"10.19224/AI2020.569","DOIUrl":"https://doi.org/10.19224/AI2020.569","url":null,"abstract":"Despite the high number of intensive care beds in German hospitals compared to other European countries, intensive care medical shortages are common in daily clinical practice. This is due to a hardly established cross-departmental discharge and transfer management with missing objective discharge criteria, lack of personnel and bed closures. Aboveaverage lengths of stays and increased readmission rates to the intensive care unit also indicate an inefficient use of resources in German hospitals. Against this background, a systematic literature search was carried out on the current state of research on discharge criteria from the intensive care unit and transfer processes to follow-up wards. Between 1983 and 2020, 1,917 sources were found, 286 were selected as full text, 104 of which were considered relevant and used as the basis for this work. Approaches, such as a root cause analy- sis of bottleneck situations including the entire hospital system with its interdependent admission, transfer and discharge processes, and the use of electronic decision support in conjunction with standardised discharge criteria can improve the use of existing intensive care capacities and lead to safer and better patient flow. For better use of resources, the therapeutic outcome must be viewed along the entire clinical pathway in order to care for the right patient at the right place and at the right time. A standardised care transition management using objective discharge criteria could help to include the various stakeholders in the discharge decision and patient-transfer process to reflect patient-, caregiver-, process, and institution-specific factors, and ultimately to manage, proactively and efficiently, the available intensive care resources. Decision support in the discharge process using self-learning systems based on available data from patient data management systems is forward-looking, but must be validated more widely in clinical practice.","PeriodicalId":55516,"journal":{"name":"Anasthesiologie & Intensivmedizin","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73554176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Entwicklung eines zentral gesteuerten Ausbildungs- und Ausstattungskonzepts für innerklinische Notfälle","authors":"H. Gässler, B. Hossfeld, J. Gräsner, M. Helm","doi":"10.19224/AI2020.040","DOIUrl":"https://doi.org/10.19224/AI2020.040","url":null,"abstract":"","PeriodicalId":55516,"journal":{"name":"Anasthesiologie & Intensivmedizin","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90289326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Influence of a structured training on the application of mechanical chest compression devices","authors":"Holger Gaessler, S. Decken, L. Lampl, M. Helm","doi":"10.19224/ai2019.104","DOIUrl":"https://doi.org/10.19224/ai2019.104","url":null,"abstract":"","PeriodicalId":55516,"journal":{"name":"Anasthesiologie & Intensivmedizin","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74385048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Wilharm, M. Kulla, M. Baacke, F. Wagner, M. Behnke, R. Lefering, H. Trentzsch, TraumaRegister Dgu
{"title":"Prehospital capnometry as quality indicator for trauma patients - initial analysis from the TraumaRegister DGU (R)","authors":"A. Wilharm, M. Kulla, M. Baacke, F. Wagner, M. Behnke, R. Lefering, H. Trentzsch, TraumaRegister Dgu","doi":"10.19224/ai2019.419","DOIUrl":"https://doi.org/10.19224/ai2019.419","url":null,"abstract":"","PeriodicalId":55516,"journal":{"name":"Anasthesiologie & Intensivmedizin","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76892002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Wurmb, T. Kerner, G. Geldner, G. Schaelte, A. Heller, B. Hossfeld, Jan-Thorsten Graesner
{"title":"Inhospital Management of major incidents and disasters - the importance of anaesthesiology","authors":"T. Wurmb, T. Kerner, G. Geldner, G. Schaelte, A. Heller, B. Hossfeld, Jan-Thorsten Graesner","doi":"10.19224/ai2019.389","DOIUrl":"https://doi.org/10.19224/ai2019.389","url":null,"abstract":"","PeriodicalId":55516,"journal":{"name":"Anasthesiologie & Intensivmedizin","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87555400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dominik Treffer, A. Weissleder, Holger Gaessler, S. Decken, Maximilian Hauptkorn, M. Helm
{"title":"Functionality and operational fitness of mechanical chest compression devices","authors":"Dominik Treffer, A. Weissleder, Holger Gaessler, S. Decken, Maximilian Hauptkorn, M. Helm","doi":"10.19224/ai2019.113","DOIUrl":"https://doi.org/10.19224/ai2019.113","url":null,"abstract":"","PeriodicalId":55516,"journal":{"name":"Anasthesiologie & Intensivmedizin","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88111644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. D. Rieg, G. Schubert, H. Schulze‐Steinen, R. Rossaint, G. Schaelte, G. Marx, M. Coburn
{"title":"Die aneurysmatisch bedingte Subarachnoidalblutung: Update","authors":"A. D. Rieg, G. Schubert, H. Schulze‐Steinen, R. Rossaint, G. Schaelte, G. Marx, M. Coburn","doi":"10.19224/AI2017.481","DOIUrl":"https://doi.org/10.19224/AI2017.481","url":null,"abstract":"","PeriodicalId":55516,"journal":{"name":"Anasthesiologie & Intensivmedizin","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77335262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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