ABCDEF
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Model input parameters
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CategoryDefinitionValueBase-case valueRange of values in sensitivity analysisSource
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CKRT demand during the initial wave of the COVID-19 pandemicIHME model update (Choose Date of Data)IHME projections from 06/1006/10/202004/22/2020, 06/10/2020IHME COVID-19 estimate downloads
http://www.healthdata.org/covid/data-downloads
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CKRT demand during the initial wave of the COVID-19 pandemicIncidence of AKI 3D requiring CKRT among hospitalized patients with COVID-19 (%)5.20%5.20%4.8 - 6.9%1. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020;323(20):2052-2059.
2. Argenziano MG, Bruce SL, Slater CL, et al. Characterization and Clinical Course of 1000 Patients with Coronavirus Disease 2019 in New York: Retrospective Case Series. BMJ. 2020;369:m1996.
3. Cummings MJ, Baldwin MR, Abrams D, et al. Epidemiology, Clinical Course, and Outcomes of Critically Ill Adults with COVID-19 in New York City: A Prospective Cohort Study. Lancet. 2020;395(10239):1763-1770.
4. Goyal P, Choi JJ, Pinheiro LC, et al. Clinical Characteristics of Covid-19 in New York City. N Engl J Med. 2020;382(24):2372-2374.
5. Hirsch JS, Ng JH, Ross DW, et al. Acute Kidney Injury in Patients Hospitalized with COVID-19. Kidney Int. 2020;98(1):209-218.
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CKRT demand during the initial wave of the COVID-19 pandemicTime from hospitalization to AKI 3D requiring CKRT among hospitalized patients with COVID-19 (days)7 days7 days5 - 10 days1. Zhou F, Yu T, Du R, et al. Clinical Course and Risk Factors for Mortality of Adult Inpatients with COVID-19 in Wuhan, China: A Retrospective Cohort Study. Lancet. 2020;395(10229):1054-1062.
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CKRT demand during the initial wave of the COVID-19 pandemicDuration of CKRT among hospitalized patients with COVID-19 (days)6 days6 days6 - 9 days1. Palevsky PM, Zhang JH, O'Connor TZ, et al. Intensity of Renal Support in Critically Ill Patients with Acute Kidney Injury. N Engl J Med. 2008;359(1):7-20.
2. Hirsch JS, Ng JH, Ross DW, et al. Acute Kidney Injury in Patients Hospitalized with COVID-19. Kidney Int. 2020;98(1):209-218.
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CKRT demand during the initial wave of the COVID-19 pandemicNon-COVID-19 CKRT demand multiplier during the COVID-19 pandemic0.400.400.25 - 0.751. Harvard Global Health Institute COVID-19 model. https://docs.google.com/spreadsheets/d/1XUVyZF3X_4m72ztFnXZFvDKn5Yys1aKgu2Zmefd7wVo/edit#gid=1576394115. Accessed July 6, 2020.
2. American Hospital Association, AHA Hospital Statistics, Chicago, IL. American Hospital Association 2018.
3. American Hospital Directory. Hospital Statistics by State. https://www.ahd.com/state_statistics.html. Accessed July 6, 2020.
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CKRT demand during the initial wave of the COVID-19 pandemic and CKRT capacityPrevalence of AKI 3D among ICU patients pre-COVID-19 (%)8.8%8.80%6.6 - 11.0% 1. Melo FAF, Macedo E, Fonseca Bezerra AC, et al. A Systematic Review and Meta-analysis of Acute Kidney Injury in the Intensive Care Units of Developed and Developing Countries. PLoS One. 2020;15(1):e0226325.
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CKRT capacityCKRT capacity multiplier1.50 capacity multiplier1.50 1.25 - 1.75Estimates based on clinical experience informed by local capacity.
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Model outcomes
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CategoryResults
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Nationwide CKRT Capacity7,032
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Nationwide CKRT demand at peak resource utilization during the COVID-19 pandemic4,985 (4,582 - 6,105)
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Nationwide CKRT machine shortage at peak resource utilization during the COVID-19 pandemic
1,088 (910 - 1,568)
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Number of states projected to encounter CKRT shortages6
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List of states projected to encounter CKRT shortagesCT, MD, MA, MI, NJ, NY,
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Number of states projected to encounter possible CKRT shortages8
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List of states projected to encounter possible CKRT shortagesAZ, CO, LA, NE, NM, RI, SC, WY,