ICU sedation, delirium & recovery
The impact of intensive care strain on patients’ outcomes—a multinational observational cohort (UNITE-COVID) study
Authors' conclusion
COVID-19 induced ICU strain had effects beyond mortality, including increases in complications. Staff pressure and lack of ICU training were related to specific complications, whilst support teams and well-being interventions were associated with improved outcomes.
Study context
- Population
- Intensive care unit (ICUs) on their day of peak bed occupancy during the COVID-19 pandemic (2020 and 2021)
- Exposure
- ICU strain metrics and mitigators vs patient outcomes
- Outcome
- Association of ICU strain metrics and mitigators with outcomes (mortality, complications, LOS)
Methodological detailspeak bed occupancy day sampling, two epochs (2020 and 2021)
- Peak bed occupancy day sampling
- Two epochs (2020 and 2021)
Main finding
As reported in the abstract
- ICU bed expansion, 2020 epoch
- 133%
- ICU bed expansion, 2021 epoch
- 163%
- Increase in patient-to-nurse ratio, 2020 epoch
- 0.4
- Increase in patient-to-nurse ratio, 2021 epoch
- 0.3
- Pressure sores reduced with support teams (regression)
- p = 0.004
- Pressure sores increased with increasing patients per nurse (regression)
- p = 0.05
- Unplanned extubations related to non-ICU trained staff working in ICU (regression)
- p = 0.02
Observational data: associations, not effects.
Original publication
The impact of intensive care strain on patients’ outcomes—a multinational observational cohort (UNITE-COVID) study. Crit Care. Published 28 July 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →