Gaga: “The Tsiodra-Lytra study” has weaknesses “

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The Mayorkin objections

The recent study of professors Tsiodra and Lytra on high mortality outside the ICU was commented by the Deputy Minister of Health, Mina Gaga, during today’s briefing, emphasizing that it shows “weaknesses”.

The Deputy Minister of Health commented that this scientific article has “weaknesses both in its data and in the way it is explained”. He added that the data is relatively small, as reported by news4health. «This study is not very clear. So we can not chat the data of the study as they have been given. It is a study. To have safe conclusions we usually want a lot of studies, we want a lot of populations, we want different data. There is very little data to answer safely what is happening “ commented characteristically.

Because it is difficult to draw conclusions from the study

Regarding the high mortality rate outside the ICU (88.4%), Ms. Gaga explained that this could be due to many reasons, such as the late arrival of COVID patients in the ICUs of hospitals, resulting in intubation and ending up in in half an hour. Therefore, according to what she said, in order to draw conclusions about mortality outside the ICU, the severity of each incident must be assessed: e.g. what age he was, when he was hospitalized, what condition he was in, if he had underlying diseases.

The Deputy Minister of Health also commented on the study’s finding that in-hospital mortality was significantly increased when there were more than 400 intubated patients. “I think it is an element that is probably not substantiated,” he commented.

Ms. Gaga underlined that every effort is made to move the cases as quickly as possible and that the average waiting time for a patient to enter the ICU is short (less than one day).

Mayorkin’s objections to the study

The professor of Epidemiology commenting on the study referred to the shortcomings of this study. He initially said that the study did not mention at all how many were vaccinated and this creates large disparities from region to region.

The second element they have not included is the boundaries of the system by region and they see it as a whole. “Not all regions have the same dynamics. “It’s an issue that needs further analysis,” he said.

What the study showed – How many people died outside the ICU

During the study (September 1, 2020 until May 6, 2021), two epidemic waves were observed in Greece. The first reached its peak in November 2020 in Central and Northern Greece while the second was related to the Alpha mutation (British) and affected Athens and the whole country.

The study analyzed 6,282 intubated cases of which 3,988 died (63.5%). Most patients spent part or all of their hospital stay in the Intensive Care Unit (5,971 / 6282). Only 5% of the people who were intubated did not enter the ICU. Among those who were not admitted to the ICU, 275 (88.4%) died compared to 3,713 (62.2%) who were admitted to the ICU.

What factors increase intracranial mortality

An increase in mortality has been found to be associated with an increase in intubated patients over 400. Also, being intubated outside the ICU was significantly associated with mortality, as was age over 60 years. In addition, the increased mortality was associated with intubation outside the Attica region, as in Thessaloniki and other parts of the country. No gender link was found but there was a slight negative time trend, indicating a gradually lower mortality as the pandemic progressed.

Based on the above, out of the 3,988 deaths, 947 are attributed to the large number of intubated COVID patients (≥200), 133 to the fact that they were outside the ICU and 656 to the fact that they were hospitalized far from Attica. A total of 1,535 deaths are attributed to these 3 factors in total. It should be noted that there was no relationship between the patient’s age and the total number of intubated patients, which proves that there is no evidence for patient selection when hospitals are filled with patients. In contrast, patients who were never admitted to the ICU were older on average (median age 73 years versus 68 years). Also, the patients in Thessaloniki were slightly younger than those in Attica and other areas (median age 67 years versus 69 years).

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