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Regional variation in medical decision making might affect ICU triage decisions. We investigate whether regional differences in ICU admission, as surrogate for triage decisions, affect in-hospital mortality in COVID-19 patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>The COMET study is a multicenter, observational cohort study, including adult patients hospitalized for COVID-19 between March 2020\u2013 July 2020. Patients\u2019 characteristics, prescribed medication, clinical characteristics, and CFS were collected. Patients from 11 European countries were included and these countries were categorized into two regions: north and south. The effects of region on ICU admission and in-hospital mortality were assessed using logistic regression analyses stratified for frailty.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Frail patients had a higher risk for ICU admission in southern compared to northern countries (OR: 1.64; 95%CI: 1.10\u20132.46), whereas fit patients had a similar risk for ICU admission in southern compared to northern countries (OR: 0.75; 95%CI: 0.55\u20131.01). There was no difference in in-hospital mortality between northern and southern countries for fit and frail patients (respectively OR: 0.82; 95% CI 0.52\u20131.29, and OR: 1.11; 95% CI: 0.74\u20131.66).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Our study shows that, despite variation in rates of ICU admission between northern and southern countries for frail patients, no difference in in-hospital mortality was observed. This might help optimize prioritization of resources in a pandemic setting while offering options for palliative care instead of ICU admission.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12879-025-10540-2","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T16:03:32Z","timestamp":1738685012000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Regional differences in triage decisions affect hospital mortality among frail COVID-19 patients in the COvid MEdicaTion study"],"prefix":"10.1186","volume":"25","author":[{"given":"Julia","family":"Minnema","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roos","family":"Sablerolles","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janneke","family":"van 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Written informed consent was not required, since this study is no subject to the Medical Research Involving Human Subjects Act (WMO) and only limited data was collected which followed routine practice. All data were treated according to the European privacy regulations and the study was performed in accordance with the declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"165"}}