Domingo Laia, Comas Mercè, Jansana Anna, Louro Javier, Tizón-Marcos Helena, Cos Maria Lourdes, Roquer Jaume, Chillarón Juan José, Cirera Isabel, Pascual-Guàrdia Sergi, Sala Maria, Castells Xavier
Department of Epidemiology and Evaluation, Hospital del Mar-IMIM, 08003 Barcelona, Spain.
Research Network on Health Services in Chronic Diseases (REDISSEC), RICAPPS, Instituto de Salud Carlos III, 28029 Madrid, Spain.
J Clin Med. 2022 Mar 22;11(7):1752. doi: 10.3390/jcm11071752.
Few studies have assessed the impact of the COVID-19 pandemic on non-COVID diseases and healthcare quality. We aimed to evaluate changes in rates of hospitalisations, complications, in-hospital mortality, and readmissions among patients with non-COVID diseases during a one-year period after the pandemic onset. From March 2018 to February 2021 a retrospective observational study of hospital admissions in a university hospital in Spain was conducted. Non-COVID hospitalisations admitted through the emergency department were compared between the pre-COVID period (n = 28,622) and the COVID period (n = 11,904). We assessed rate ratios (RaR), comparing the weekly number of admissions and risk ratios (RR) to examine rates of complications, in-hospital mortality, readmissions, and severity. Statistical significance was set at p < 0.05. The weekly admission rate dropped by 20.8% during the complete lockdown. We observed significant reductions in admissions related to diseases of the respiratory system and circulatory system. Admissions for endocrine and metabolic diseases increased. The complication rates increased (RR = 1.21, 95% CI: 1.05;1.4), while in-hospital mortality rates held steady during the COVID period (RR = 1.09, 95% CI: 0.98;1.2). Hospital efforts to maintain quality and safety standards despite disruptions translated into a moderate increase in complications but not in in-hospital mortality. Reduced hospitalisations for conditions requiring timely treatment may have significant public health consequences.
很少有研究评估新冠疫情对非新冠疾病及医疗质量的影响。我们旨在评估疫情爆发后一年内非新冠疾病患者的住院率、并发症、院内死亡率及再入院率的变化。2018年3月至2021年2月，在西班牙一家大学医院开展了一项关于住院情况的回顾性观察研究。比较了急诊科收治的非新冠住院患者在新冠疫情前时期（n = 28,622）和新冠疫情时期（n = 11,904）的情况。我们评估了率比（RaR），比较每周的入院人数，并评估风险比（RR）以检查并发症、院内死亡率、再入院率及疾病严重程度。设定统计学显著性为p < 0.05。在全面封锁期间，每周入院率下降了20.8%。我们观察到呼吸系统疾病和循环系统疾病相关的入院人数显著减少。内分泌和代谢疾病的入院人数增加。并发症发生率上升（RR = 1.21，95%置信区间：1.05；1.4），而在新冠疫情期间院内死亡率保持稳定（RR = 1.09，95%置信区间：0.98；1.2）。尽管出现了干扰情况，但医院为维持质量和安全标准所做的努力导致并发症略有增加，但院内死亡率并未上升。因需要及时治疗的疾病而导致的住院人数减少可能会产生重大的公共卫生后果。
