Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
PLoS One. 2021 Mar 3;16(3):e0247686. doi: 10.1371/journal.pone.0247686. eCollection 2021.
The aim of this study was to investigate possible patterns of demand for chest imaging during the first wave of the SARS-CoV-2 pandemic and derive a decision aid for the allocation of resources in future pandemic challenges.
Time data of requests for patients with suspected or confirmed coronavirus disease 2019 (COVID-19) lung disease were analyzed between February 27th and May 27th 2020. A multinomial logistic regression model was used to evaluate differences in the number of requests between 3 time intervals (I1: 6am - 2pm, I2: 2pm - 10pm, I3: 10pm - 6am). A cosinor model was applied to investigate the demand per hour. Requests per day were compared to the number of regional COVID-19 cases.
551 COVID-19 related chest imagings (32.8% outpatients, 67.2% in-patients) of 243 patients were conducted (33.3% female, 66.7% male, mean age 60 ± 17 years). Most exams for outpatients were required during I2 (I1 vs. I2: odds ratio (OR) = 0.73, 95% confidence interval (CI) 0.62-0.86, p = 0.01; I2 vs. I3: OR = 1.24, 95% CI 1.04-1.48, p = 0.03) with an acrophase at 7:29 pm. Requests for in-patients decreased from I1 to I3 (I1 vs. I2: OR = 1.24, 95% CI 1.09-1.41, p = 0.01; I2 vs. I3: OR = 1.16, 95% CI 1.05-1.28, p = 0.01) with an acrophase at 12:51 pm. The number of requests per day for outpatients developed similarly to regional cases while demand for in-patients increased later and persisted longer.
The demand for COVID-19 related chest imaging displayed distinct distribution patterns depending on the sector of patient care and point of time during the SARS-CoV-2 pandemic. These patterns should be considered in the allocation of resources in future pandemic challenges with similar disease characteristics.
本研究旨在探讨 SARS-CoV-2 大流行第一波期间对胸部成像的需求模式，并为未来大流行挑战中的资源分配制定决策辅助工具。
分析了 2020 年 2 月 27 日至 5 月 27 日期间疑似或确诊 2019 年冠状病毒病（COVID-19）肺部疾病患者的请求时间数据。使用多项逻辑回归模型评估 3 个时间段（I1：上午 6 点至下午 2 点，I2：下午 2 点至晚上 10 点，I3：晚上 10 点至上午 6 点）之间请求数量的差异。应用余弦模型研究每小时的需求。每日请求数与区域 COVID-19 病例数进行比较。
共进行了 243 例患者的 551 例 COVID-19 相关胸部影像学检查（32.8%为门诊患者，67.2%为住院患者）（33.3%为女性，66.7%为男性，平均年龄 60 ± 17 岁）。门诊患者的大多数检查是在 I2 期间进行的（I1 与 I2：优势比（OR）= 0.73，95%置信区间（CI）0.62-0.86，p = 0.01；I2 与 I3：OR = 1.24，95%CI 1.04-1.48，p = 0.03），高峰时间为晚上 7 点 29 分。住院患者的请求从 I1 减少到 I3（I1 与 I2：OR = 1.24，95%CI 1.09-1.41，p = 0.01；I2 与 I3：OR = 1.16，95%CI 1.05-1.28，p = 0.01），高峰时间为晚上 12 点 51 分。门诊患者的每日请求数量与区域病例的发展相似，而住院患者的需求增加较晚且持续时间更长。
COVID-19 相关胸部成像的需求根据大流行期间患者护理部门和时间点的不同呈现出不同的分布模式。在未来具有类似疾病特征的大流行挑战中，应考虑这些模式来分配资源。
