• Matteo Nocci, Luca Ragazzoni, Francesco Barone-Adesi, Ives Hubloue, Stefano Romagnoli, Adriano Peris, Pietro Bertini, Sabino Scolletta, Fabrizio Cipollini, Maria T Mechi, and Della CorteFrancescoFCRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy..
• Section of Anesthesia and Critical Care, Department of Anesthesia and Critical Care, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy - matteo.nocci@gmail.com.
• Minerva Anestesiol. 2022 Nov 1; 88 (11): 928938928-938.

BackgroundThe COVID-19 pandemic has provided an unprecedented scenario to deepen knowledge of surge capacity (SC), assessment of which remains a challenge. This study reports a large-scale experience of a multi-hospital network, with the aim of evaluating the characteristics of different hospitals involved in the response and of measuring a real-time SC based on two complementary modalities (actual, base) referring to the intensive care units (ICU).MethodsData analysis referred to two consecutive pandemic waves (March-December 2020). Regarding SC, two different levels of analysis are considered: single hospital category (referring to a six-level categorization based on the number of hospital beds) and multi-hospital wide (referring to the response of the entire hospital network).ResultsDuring the period of 114 days, the analysis revealed a key role of the biggest hospitals (>Category-4) in terms of involvement in the pandemic response. In terms of SC, Category-4 hospitals showed the highest mean SC values, irrespective of the calculation method and level of analysis. At the multi-hospital level, the analysis revealed an overall ICU-SC (base) of 84.4% and an ICU-SC (actual) of 106.5%.ConclusionsThe results provide benchmarks to better understand ICU hospital response capacity, highlighting the need for a more flexible approach to SC definition.

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