To examine whether there is geographical variation in the use of intensive care resources in Denmark concerning both intensive care unit (ICU) admission and use of specific interventions. Substantial variation in use of intensive care has been reported between countries and within the US, however, data on geographical variation in use within more homogenous tax-supported health care systems are sparse.
We conducted a population-based cross-sectional study based on linkage of national medical registries including all Danish residents between 2008 and 2012 using population statistics from Statistics Denmark. Data on ICU admissions and interventions, including mechanical ventilation, noninvasive ventilation, acute renal replacement therapy, and treatment with inotropes/vasopressors, were obtained from the Danish Intensive Care Database. Data on patients' residence at the time of admission were obtained from the Danish National Registry of Patients.
The overall age- and gender standardized number of ICU patients per 1000 person-years for the 5-year period was 4.3 patients (95 % CI, 4.2; 4.3) ranging from 3.7 (95 % CI, 3.6; 3.7) to 5.1 patients per 1000 person-years (95 % CI, 5.0; 5.2) in the five regions of Denmark and from 2.8 (95 % CI, 2.8; 3.0) to 23.1 patients per 1000 person-years (95 % CI, 13.0; 33.1) in the 98 municipalities. The age-, gender-, and comorbidity standardized proportion of use of interventions among ICU patients also differed across regions and municipalities.
There was only minimal geographical variation in the use of intensive care admissions and interventions at the regional level in Denmark, but more pronounced variation at the municipality level.
Fourty-five cases of percutaneous dilatational tracheostomy (PDT) performed in the intensive care unit, Kolding Hospital, are reported in a retrospective study. All patients (mean age 60.8 years) had been on a ventilator due to critical diseases and had been subjected to translaryngeal intubation for an average of 6.1 days (range 1-12). PDT was uncomplicated in 41 cases (91%). Early bleeding, which required minor intervention, was described in three cases (7%). There was one case (2%) of minor bleeding seven days after PDT during haemodialysis. There had been no procedure-related death, and no life-threatening complications such as pneumothorax, paratracheal tube position or bleeding requiring transfusion were seen. Nineteen patients (42%) died due to progression of their underlying diseases with the tracheostomy functioning well, the mean cannulation time being 23.3 days. Twenty-six patients (58%) lived to decannulation with a mean length of cannulation of 13.7 days. The PDT procedure has the advantage of being bedside, thus avoiding transportation of a critically ill patient to the operating theatre.
The Public Health Agency of Sweden has analyzed how many pregnant and postpartum women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been treated in intensive care units (ICU) in Sweden between 19 March and 20 April 2020 compared with non-pregnant women of similar age. Cases were identified in a special reporting module within the Swedish Intensive Care Registry (SIR). Fifty-three women aged 20-45 years with SARS-CoV-2 were reported in SIR, and 13 of these women were either pregnant or postpartum (