University of Eastern Finland, School of Medicine, Yliopistonranta 1, PL 1627, 70211, Kuopio, Finland.
Mikkeli Central Hospital, Porrassalmenkatu 35-37, 50100, Mikkeli, Finland.
Scand J Trauma Resusc Emerg Med. 2020 Dec 4;28(1):114. doi: 10.1186/s13049-020-00810-0.
COVID-19 outbreak lead to nationwide lockdown in Finland on the March 16th, 2020. Previous data regarding to the patient load in the emergency departments during pandemics is scarce. Our aim is to describe the effect of national lockdown and social distancing on the number and reasons for emergency department (ED) visits and inpatient admissions in three large volume hospitals prior to and after the outbreak of the COVID-19 epidemic in Finland.
Data for this register-based retrospective cohort study were collected from three large ED's in Finland, covering 1/6 of the Finnish population. All patients visiting ED's six weeks before and six weeks after the lockdown were included. Pediatric and gynecological patients were excluded. Numbers and reasons for ED visits and inpatient admissions were collected. Corresponding time period in 2019 was used as reference.
A total of 40,653 ED visits and 12,226 inpatient admissions were analyzed. The total number of ED visits decreased 16% after the lockdown, whereas the number of inpatient admissions decreased 15% (p < 0.001). This change in inpatient admissions was similar in all participating hospitals. Visits due to back or limb pain decreased 31% and infectious diseases 28%. The visit rate and inpatient admissions due to acute myocardial infarction and strokes remained stable throughout the study period. Interestingly, the rate of inpatient admissions due to psychiatric diagnoses remained unchanged, although the ED visit rate decreased by 19%. The number of ED visits (n = 282) and inpatient admissions (n = 55) due to COVID-19 remained low in the participating hospitals.
Changes in ED visits and inpatient admissions prior to and during the early phase of the COVID-19 outbreak were unpredictable, and our results may help hospitals and especially ED's focus their resources better. Surprisingly, there was a major decrease in the rate of ED visits due to back or limb pain and not so surprisingly in infectious diseases. Rates of acute myocardial infarctions and cerebral strokes remained stable. In summary, stabile resources for the treatment of patients with severe diseases will be needed in hospitals and ED's.
2020 年 3 月 16 日，芬兰因 COVID-19 疫情爆发而实施全国封锁。此前关于大流行期间急诊科患者量的数据很少。我们的目的是描述全国封锁和社会隔离对芬兰 COVID-19 疫情爆发前后三家大医院急诊科就诊人数和原因的影响。
本基于登记的回顾性队列研究的数据来自芬兰的三个大型急诊科，覆盖了芬兰六分之一的人口。所有在封锁前六周和封锁后六周内就诊于急诊科的患者均被纳入研究。排除儿科和妇科患者。收集急诊科就诊人数和原因以及住院人数。使用 2019 年同期作为参考。
共分析了 40653 次急诊科就诊和 12226 次住院治疗。封锁后，急诊科就诊总数下降了 16%，而住院人数下降了 15%（p<0.001）。所有参与医院的住院人数变化相似。因背部或四肢疼痛就诊的人数下降了 31%，传染病下降了 28%。急性心肌梗死和中风的就诊率和住院率在整个研究期间保持稳定。有趣的是，尽管急诊科就诊率下降了 19%，但因精神科诊断住院的比例保持不变。参与医院的 COVID-19 所致的急诊科就诊（n=282）和住院治疗（n=55）的数量仍然较低。
COVID-19 爆发前后急诊科就诊和住院治疗人数的变化是不可预测的，我们的研究结果可能有助于医院，尤其是急诊科更好地分配资源。令人惊讶的是，因背部或四肢疼痛就诊的人数显著减少，而传染病就诊人数则相应减少。急性心肌梗死和中风的发生率保持稳定。总之，医院和急诊科需要稳定的资源来治疗严重疾病的患者。
