Background The COVID-19 pandemic resulted in a large number of critical care admissions. While national reports have described the outcomes of patients with COVID-19, there is limited international data of the pandemic impact on non-COVID-19 patients requiring intensive care treatment. Methods We conducted an international, retrospective cohort study using 2019 and 2020 data from 11 national clinical quality registries covering 15 countries. Non-COVID-19 admissions in 2020 were compared with all admissions in 2019, prepandemic. The primary outcome was intensive care unit (ICU) mortality. Secondary outcomes included in-hospital mortality and standardised mortality ratio (SMR). Analyses were stratified by the country income level(s) of each registry. Findings Among 1 642 632 non-COVID-19 admissions, there was an increase in ICU mortality between 2019 (9.3%) and 2020 (10.4%), OR=1.15 (95% CI 1.14 to 1.17, p<0.001). Increased mortality was observed in middle-income countries (OR 1.25 95% CI 1.23 to 1.26), while mortality decreased in high-income countries (OR=0.96 95% CI 0.94 to 0.98). Hospital mortality and SMR trends for each registry were consistent with the observed ICU mortality findings. The burden of COVID-19 was highly variable, with COVID-19 ICU patient-days per bed ranging from 0.4 to 81.6 between registries. This alone did not explain the observed non-COVID-19 mortality changes. Interpretation Increased ICU mortality occurred among non-COVID-19 patients during the pandemic, driven by increased mortality in middle-income countries, while mortality decreased in high-income countries. The causes for this inequity are likely multi-factorial, but healthcare spending, policy pandemic responses, and ICU strain may play significant roles. Data may be obtained from a third party and are not publicly available. Requests for data will be subject to the requirements and policies of each CQR. Requests should be directed to the corresponding author.

中文翻译：

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大流行期间非 COVID-19 重症监护室入院情况：一项基于跨国登记的研究


背景 COVID-19 大流行导致大量患者入院重症监护。虽然国家报告描述了 COVID-19 患者的结果，但有关大流行对需要重症监护治疗的非 COVID-19 患者影响的国际数据有限。方法 我们使用来自 15 个国家的 11 个国家临床质量注册中心的 2019 年和 2020 年数据进行了一项国际回顾性队列研究。将 2020 年非 COVID-19 入院人数与 2019 年大流行前的所有入院人数进行了比较。主要结局是重症监护病房（ICU）死亡率。次要结局包括院内死亡率和标准化死亡率（SMR）。分析按每个登记处的国家收入水平进行分层。结果 在 1 642 632 例非 COVID-19 入院患者中，2019 年 (9.3%) 至 2020 年 (10.4%) 期间 ICU 死亡率有所增加，OR=1.15（95% CI 1.14 至 1.17，p<0.001）。中等收入国家死亡率增加（OR 1.25 95% CI 1.23 至 1.26），而高收入国家死亡率下降（OR = 0.96 95% CI 0.94 至 0.98）。每个登记处的医院死亡率和 SMR 趋势与观察到的 ICU 死亡率结果一致。 COVID-19 的负担差异很大，不同登记处的每张床位的 COVID-19 ICU 患者天数从 0.4 到 81.6 不等。仅此一点并不能解释观察到的非 COVID-19 死亡率变化。解释 在大流行期间，由于中等收入国家死亡率增加，非 COVID-19 患者的 ICU 死亡率增加，而高收入国家死亡率下降。造成这种不平等的原因可能是多因素的，但医疗支出、流行病政策应对和重症监护病房的压力可能发挥重要作用。 数据可能从第三方获得，并且不公开。数据请求将遵守每个 CQR 的要求和政策。请求应直接发送给通讯作者。