Department of Emergency Medicine, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Department of Emergency Medicine, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; Department of Emergency Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Am J Emerg Med. 2022 Aug;58:100-105. doi: 10.1016/j.ajem.2022.05.049. Epub 2022 May 30.
The coronavirus disease 2019 (COVID-19) pandemic situation is a state that has had a great impact on the medical system and society. To respond to the pandemic situation, various methods, such as a pre-triage system, are being implemented in the emergency medical field. However, there are insufficient studies on the effects of this pandemic situation on patients visiting the emergency department (ED), especially those with cardio/cerebrovascular diseases (CVD) classified as time-dependent emergencies.
We performed a retrospective analysis of a cohort of patients from April 2020 to December 2020 (April 2020 was when the pre-triage system was established) compared to a parallel comparison patient cohort from 2019. The primary outcome was in-hospital mortality. CVD was defined by the patient's final diagnosis.
During the same period, the number of patients who had visited the ED after COVID-19 had decreased to 79.1% of the number of patients who had visited the ED before COVID-19. The overall patient mortality and the mortality in the patients cardiovascular disease had both increased, while the mortality from cerebrovascular disease did not increase. Meanwhile, the ED length of stay had increased in all patients but did not increase in the patients with cardiovascular disease.
As with prior studies conducted in other regions, in our study, the total number of ED visits were decreased compared to before COVID-19. The overall mortality had increased, particularly in the patients with cardiovascular disease.
2019 年冠状病毒病(COVID-19)大流行是对医疗系统和社会产生重大影响的一种状态。为应对大流行情况,急救医学领域正在实施各种方法,如预检分诊系统。然而,对于大流行情况对急诊部(ED)就诊患者的影响,特别是对分类为时间依赖性急症的心血管/脑血管疾病(CVD)患者的影响,研究还不够充分。
我们对 2020 年 4 月至 2020 年 12 月(建立预检分诊系统的 2020 年 4 月)的患者队列进行了回顾性分析,并与 2019 年的平行比较患者队列进行了比较。主要结局是院内死亡率。CVD 是根据患者的最终诊断来定义的。
同期,COVID-19 后到 ED 就诊的患者数量减少到 COVID-19 前就诊患者数量的 79.1%。总体患者死亡率和心血管疾病患者死亡率均有所增加,而脑血管疾病患者死亡率没有增加。同时,所有患者的 ED 停留时间都增加了,但心血管疾病患者的 ED 停留时间没有增加。
与在其他地区进行的先前研究一样,在我们的研究中,与 COVID-19 之前相比,ED 就诊总人数减少。总死亡率有所增加,特别是心血管疾病患者。