Publications by authors named "E Kursumovic"

4 Publications

  • Page 1 of 1

The impact of COVID-19 on anaesthesia and critical care services in the UK: a serial service evaluation.

Anaesthesia 2021 May 18. Epub 2021 May 18.

Department of Anaesthesia and Intensive Care Medicine, Southmead Hospital, Bristol, UK.

Between October 2020 and January 2021, we conducted three national surveys to track anaesthetic, surgical and critical care activity during the second COVID-19 pandemic wave in the UK. We surveyed all NHS hospitals where surgery is undertaken. Response rates, by round, were 64%, 56% and 51%. Despite important regional variations, the surveys showed increasing systemic pressure on anaesthetic and peri-operative services due to the need to support critical care pandemic demands. During Rounds 1 and 2, approximately one in eight anaesthetic staff were not available for anaesthetic work. Approximately one in five operating theatres were closed and activity fell in those that were open. Some mitigation was achieved by relocation of surgical activity to other locations. Approximately one-quarter of all surgical activity was lost, with paediatric and non-cancer surgery most impacted. During January 2021, the system was largely overwhelmed. Almost one-third of anaesthesia staff were unavailable, 42% of operating theatres were closed, national surgical activity reduced to less than half, including reduced cancer and emergency surgery. Redeployed anaesthesia staff increased the critical care workforce by 125%. Three-quarters of critical care units were so expanded that planned surgery could not be safely resumed. At all times, the greatest resource limitation was staff. Due to lower response rates from the most pressed regions and hospitals, these results may underestimate the true impact. These findings have important implications for understanding what has happened during the COVID-19 pandemic, planning recovery and building a system that will better respond to future waves or new epidemics.
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http://dx.doi.org/10.1111/anae.15512DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8222939PMC
May 2021

The 7th UK National Audit Project (NAP7). The challenges of defining, studying and learning from peri-operative cardiac arrest.

Anaesthesia 2021 08 13;76(8):1026-1030. Epub 2021 May 13.

Department of Anaesthesia and Intensive Care Medicine, Southmead Hospital, Bristol, UK.

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http://dx.doi.org/10.1111/anae.15509DOI Listing
August 2021

Mortality in patients admitted to intensive care with COVID-19: an updated systematic review and meta-analysis of observational studies.

Anaesthesia 2021 04 1;76(4):537-548. Epub 2021 Feb 1.

Department of Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.

The COVID-19 pandemic continues to cause critical illness and deaths internationally. Up to 31 May 2020, mortality in patients admitted to intensive care units (ICU) with COVID-19 was 41.6%. Since then, changes in therapeutics and management may have improved outcomes. Also, data from countries affected later in the pandemic are now available. We searched MEDLINE, Embase, PubMed and Cochrane databases up to 30 September 2020 for studies reporting ICU mortality among adult patients with COVID-19 and present an updated systematic review and meta-analysis. The primary outcome measure was death in intensive care as a proportion of completed ICU admissions, either through discharge from intensive care or death. We identified 52 observational studies including 43,128 patients, and first reports from the Middle East, South Asia and Australasia, as well as four national or regional registries. Reported mortality was lower in registries compared with other reports. In two regions, mortality differed significantly from all others, being higher in the Middle East and lower in a single registry study from Australasia. Although ICU mortality (95%CI) was lower than reported in June (35.5% (31.3-39.9%) vs. 41.6% (34.0-49.7%)), the absence of patient-level data prevents a definitive evaluation. A lack of standardisation of reporting prevents comparison of cohorts in terms of underlying risk, severity of illness or outcomes. We found that the decrease in ICU mortality from COVID-19 has reduced or plateaued since May 2020 and note the possibility of some geographical variation. More standardisation in reporting would improve the ability to compare outcomes from different reports.
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http://dx.doi.org/10.1111/anae.15425DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8013495PMC
April 2021

Deaths in healthcare workers due to COVID-19: the need for robust data and analysis.

Anaesthesia 2020 08 23;75(8):989-992. Epub 2020 May 23.

Department of Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.

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http://dx.doi.org/10.1111/anae.15116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7272944PMC
August 2020
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