Table 3.
Univariate and Multivariate Predictors of Limiting Mechanical Ventilation and Changes in CPR Policy
| Characteristic | RR (95% CI) | P Value | ARR (95% CI) | P Value |
|---|---|---|---|---|
| Mechanical ventilation limited in patients with COVID-19 | ||||
| Region | ||||
| North America | Ref | Ref | ||
| East Asia and Pacific | 1.58 (1.07-2.33) | .02 | 2.25 (1.05-4.85) | .04 |
| Europe and Central Asia | 3.17 (2.53-3.98) | < .001 | 2.95 (2.30-3.79) | < .001 |
| Latin America and the Caribbean | 2.09 (0.98-4.45) | .06 | 1.83 (0.76-4.41) | .17 |
| Middle East and North Africa | 3.38 (1.91-5.96) | < .001 | 2.93 (1.15-7.46) | .02 |
| South Asia | 3.55 (1.66-7.57) | < .001 | 4.20 (1.52-11.6) | .01 |
| Sub-Saharan Africa | 2.89 (0.72-11.7) | .14 | 2.90 (0.61-13.8) | .18 |
| Reported lack of stuff, staff, and space | ||||
| Limited availability of PAPRs | 1.62 (1.12-2.32) | .01 | 1.49 (0.98-2.27) | .06 |
| Limited ventilator availability | 2.99 (2.39-3.74) | < .001 | 2.10 (1.61-2.74) | < .001 |
| Lack of intensivists | 1.99 (1.58-2.52) | < .001 | 1.11 (0.83-1.50) | .47 |
| Lack of nurses | 1.78 (1.45-2.19) | < .001 | 1.07 (0.82-1.39) | .62 |
| Lack of ICU beds | 2.02 (1.56-2.61) | < .001 | 1.21 (0.88-1.65) | .24 |
| No. of patients with COVID-19cared for | ||||
| < 10 | Ref | Ref | ||
| 10-50 | 1.16 (0.92-1.46) | .2 | 1.03 (0.78-1.35) | .19 |
| > 50 | 1.73 (1.28-2.35) | < .001 | 1.40 (0.98-1.99) | .06 |
| COVID-19 severity indexa | ||||
| Less severe | Ref | Ref | ||
| Most severe | 0.78 (0.60-1.02) | .07 | 1.34 (0.69-2.58) | .38 |
| CPR and DNR policies and practices changed since COVID-19 | ||||
| Region | ||||
| North America | Ref | Ref | ||
| East Asia and Pacific | 1.04 (0.87-1.24) | .68 | 1.23 (0.82-1.85) | .32 |
| Europe and Central Asia | 0.87 (0.77-0.99) | .04 | 0.86 (0.76-0.99) | .03 |
| Latin America and the Caribbean | 0.95 (0.63-1.46) | .83 | 1.04 (0.65-1.66) | .87 |
| Middle East and North Africa | 0.87 (0.58-1.32) | .51 | 1.02 (0.57-1.82) | .96 |
| South Asia | 1.03 (0.61-1.75) | .9 | 1.04 (0.59-1.80) | .9 |
| Sub-Saharan Africa | 1.05 (0.44-2.54) | .91 | 1.23 (0.47-3.19) | .67 |
| Reported lack of stuff, staff, and space | ||||
| Limited availability of PAPRs | 1.14 (0.98-1.34) | .09 | 1.12 (0.96-1.31) | .16 |
| Limited ventilator availability | 1.04 (0.89-1.21) | .61 | … | |
| Lack of intensivists | 1.09 (0.95-1.25) | .22 | … | |
| Lack of nurses | 1.11 (0.99-1.23) | .06 | 0.89 (0.80-1.00) | .05 |
| Lack of ICU beds | 1.12 (0.96-1.30) | .14 | … | |
| No. of patients with COVID-19 cared for | ||||
| < 10 | Ref | Ref | ||
| 10-50 | 1.03 (0.92-1.15) | .61 | … | |
| > 50 | 1.08 (0.91-1.27) | .4 | … | |
| COVID-19 severity indexa | ||||
| Less severe | Ref | Ref | ||
| Most severe | 1.02 (0.88-1.17) | .83 | 1.19 (0.82-1.72) | .37 |
The severity index indicates daily deaths by population during the time of survey administration. Physicians in training include residents and fellows. Time from peak (mortality) was not associated with outcomes in univariate or multivariate regressions (data not shown). Variables not statistically associated with the outcomes in univariate regression or whose inclusion did not improve model fit were not included in the multivariate regression. No. of observations for multivariate regressions: mechanical ventilation limited (n = 2,231), CPR and DNR policies and practices changed since COVID-19 (n = 2,230), emotional distress and burnout (n = 2,477). ARR = absolute risk reduction; DNR = do not resuscitate; Ref = reference; RR = relative risk. See Tables 1 and 2 legends for expansion of other abbreviations.