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Projects | In Progress

South Africa ICU Capacity Strain (SA-ICU-Strain) Study

Research Areas

Principal Investigator

Headshot of George Anesi
MD, MSCE, MBE, FCCM, ATSF

George Anesi

PAIR Center Research Team

Headshot of Gary Weissman
MD, MSHP

Gary Weissman

Headshot of Rachel Kohn
MD, MSCE

Rachel Kohn

Headshot of Scott Halpern
MD, PhD

Scott Halpern

Topics

Overview

SA-ICU-Strain is a multisite longitudinal cohort study of critical care delivery and outcomes and capacity strain in the South African public health system, and a collaboration between Penn Medicine, the University of KwaZulu-Natal Nelson R. Mandela School of Medicine, and the KwaZulu-Natal Department of Health, including more than 8,000-patients.

In parallel to its research aims, the SA-ICU-Strain Study Group is a forum for bidirectional mentorship. Study Group manuscripts include the published theses of South African M.Med students co-mentored by Penn and University of KwaZulu-Natal faculty members, as well as manuscripts led by Penn trainees. Research mentees have since completed subspeciality training and are now appointed as faculty members in both the U.S. and South Africa.

Results & Impact

The study group has reported on the following:

  1. A novel evaluation of the relationship between ICU referral burden and ICU care delivery and outcomes in a resource-limited setting,
  2. ICU outcomes relative to pre-ICU length of stay in the context of persistent ICU bed shortages,
  3. Acuity scoring performance,
  4. Greater pandemic-era hospital resiliency in a resource-limited setting, and
  5. Operationalizing the new Global Definition of ARDS.

SA-ICU-Strain Study Group manuscripts have been published in Chest Critical Care, Journal of Intensive Care Medicine, African Journal of Thoracic and Critical Care Medicine, and Southern African Journal of Critical Care. Study Group results have been presented at the American Thoracic Society (ATS) International Conference, Society of Critical Care Medicine (SCCM) Critical Care Congress, and Critical Care Society of Southern Africa (CCSSA) Critical Care Congress.

Read two editorials discussing SA-ICU-Strain work: de Vasconcellos (2021) & Paruk (2021).

  • Graph showing ICU occupancy and SARS-CoV-2 cases and variant surges in 2 public hospitals in South Africa.
    Fig 1. ICU occupancy and SARS-CoV-2 cases and variant surges in 2 public hospitals in South Africa. (Anesi GL, et al. CHEST Crit Care. 2023. doi:10.1016/j.chstcc.2023.100005)
  • Plot showing ICU mortality of Global Definition–only ARDS versus Berlin Definition ARDS by subgroups.
    Fig 2. ICU mortality of Global Definition–only ARDS versus Berlin Definition ARDS by subgroups. (Anesi GL, et al. CHEST Crit Care. 2024. doi:10.1016/j.chstcc.2024.100103)
  • Plot showing ICU mortality across ARDS cohorts and oxygenation
    Fig 3. ICU mortality across ARDS cohorts and oxygenation severity levels. (Anesi GL, et al. CHEST Crit Care. 2024. doi:10.1016/j.chstcc.2024.100103)
  • Fig 1. ICU occupancy and SARS-CoV-2 cases and variant surges in 2 public hospitals in South Africa. (Anesi GL, et al. CHEST Crit Care. 2023. doi:10.1016/j.chstcc.2023.100005)
  • Fig 2. ICU mortality of Global Definition–only ARDS versus Berlin Definition ARDS by subgroups. (Anesi GL, et al. CHEST Crit Care. 2024. doi:10.1016/j.chstcc.2024.100103)
  • Fig 3. ICU mortality across ARDS cohorts and oxygenation severity levels. (Anesi GL, et al. CHEST Crit Care. 2024. doi:10.1016/j.chstcc.2024.100103)

Partnering Health Systems

Penn Medicine
University of KwaZulu-Natal Nelson R. Mandela School of Medicine
KwaZulu-Natal Department of Health

Sponsors

Leonard Davis Institute of Health Economics

Related Publications

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