{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T06:40:54Z","timestamp":1769150454988,"version":"3.49.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T00:00:00Z","timestamp":1671753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Healthcare saturation has been a prominent worry during the COVID-19 pandemic. Increase of hospital beds with mechanical ventilators has been central in Mexico's approach, but it is not known whether this actually improves access to care and the resulting quality of it. This study aimed to determine the impact of healthcare strain and other pre-specified variables on dying from coronavirus disease 2019 (COVID-19) without receiving invasive mechanical ventilation (IMV).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective cohort study was conducted using open data from Mexico City between 8 May 2020 and 5 January 2021. We performed Cox proportional hazards models to identify the strength of the association between proposed variables and the outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 33\u2009797 hospitalized patients with suspected or confirmed COVID-19, 19\u00a0820 (58.6%) did not require IMV and survived, 5414 (16.1%) required IMV and were intubated and 8563 (25.3%) required IMV but died without receiving it. A greater occupation of IMV-capable beds increased the hazard of death without receiving IMV (hazard ratio [HR] 1.56, comparing 90% with 50% occupation). Private healthcare was the most protective factor for death without IMV (HR 0.14).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Higher hospital bed saturation increased the hazard of dying without being intubated and worsened the outcomes among mechanically ventilated patients. Older age also increased the hazard of the outcomes, while private healthcare dramatically decreased them.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/trstmh\/trac123","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T18:11:04Z","timestamp":1671819064000},"page":"383-390","source":"Crossref","is-referenced-by-count":7,"title":["Impact of healthcare strain on access to mechanical ventilation and mortality of hospitalized COVID-19 patients: a retrospective cohort study"],"prefix":"10.1093","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8859-9115","authenticated-orcid":false,"given":"Isaac","family":"N\u00fa\u00f1ez","sequence":"first","affiliation":[{"name":"Department of Medical Education, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Vasco de Quiroga #15, Belisario Dom\u00ednguez Secci\u00f3n XVI, Tlalpan, Mexico City , Mexico 14080"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Soto-Mota","sequence":"additional","affiliation":[{"name":"Metabolic Diseases Research Unit, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Vasco de Quiroga #15, Belisario Dom\u00ednguez Secci\u00f3n XVI, Tlalpan, Mexico City , Mexico 14080"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,12,23]]},"reference":[{"issue":"10249","key":"2023050217522433600_bib1","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/S0140-6736(20)31749-9","article-title":"Humanitarian crises in a global pandemic","volume":"396","author":"The Lancet","year":"2020","journal-title":"Lancet"},{"issue":"3","key":"2023050217522433600_bib2","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1093\/ije\/dyab034","article-title":"Modelling intensive care unit capacity under different epidemiological scenarios of 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