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2019冠状病毒病对接受紧急转运患者死亡率的影响:一项基于人群的横断面研究。

Impact of coronavirus disease 2019 on the mortality of patients who received emergency transportation: a population-based cross-sectional study.

作者信息

Nakao Shota, Masui Jun, Katayama Yusuke, Kitamura Tetsuhisa, Matsuoka Tetsuya

机构信息

Rinku General Medical Center Senshu Trauma and Critical Care Center Izumisano Japan.

Working Group to Utilize ORION in Osaka Prefecture Osaka Japan.

出版信息

Acute Med Surg. 2023 Jan 10;10(1):e813. doi: 10.1002/ams2.813. eCollection 2023 Jan-Dec.

Abstract

AIM

The spread of coronavirus disease 2019 (COVID-19) has a widespread impact on emergency medical care systems. However, its effects on the mortality of emergency transportation patients are unclear. This population-based, cross-sectional study investigated how COVID-19 impacted the mortality and outcomes of emergency transportation patients.

METHODS

We compared mortality in the emergency department and at day 21 after an emergency visit for patients transported by ambulance to medical facilities in the Osaka Prefecture, Japan, between January 29 and December 31, 2020 (first pandemic year) and between January 29 and December 31, 2019 (immediate pre-pandemic year; 804,718 patients in total), using multivariable analysis to adjust for potential confounders.

RESULTS

During the first pandemic year, 50,446 fewer patients received emergency transportation compared with the immediate prepandemic year. Emergency department deaths increased by 603 during the first pandemic year (4,922 versus 4,319 deaths) and 640 within 21 days (14,569 versus 13,929 deaths). Multivariable analysis revealed an association between the first pandemic year and increased mortality rates among patients given emergency transportation compared with the immediate prepandemic year (odds ratio for emergency department deaths 1.31; 95% confidence interval 1.26-1.38; odds ratio for deaths within 21 days 1.17; 95% confidence interval 1.14-1.20).

CONCLUSIONS

The study results indicate that the spread of COVID-19 impacted the mortality of patients who received emergency transportation. Further studies are expected to clarify the impact of COVID-19 on emergency medical care systems.

摘要

目的

2019冠状病毒病(COVID-19)的传播对紧急医疗系统产生了广泛影响。然而,其对紧急转运患者死亡率的影响尚不清楚。这项基于人群的横断面研究调查了COVID-19如何影响紧急转运患者的死亡率和转归。

方法

我们比较了2020年1月29日至12月31日(疫情第一年)和2019年1月29日至12月31日(疫情前紧邻年份;总共804,718例患者)期间,在日本大阪府由救护车转运至医疗机构的患者在急诊科的死亡率以及急诊就诊后第21天的死亡率,采用多变量分析来调整潜在混杂因素。

结果

在疫情第一年,与紧邻的疫情前一年相比,接受紧急转运的患者减少了50,446例。疫情第一年急诊科死亡人数增加了603例(4,922例死亡 vs. 4,319例死亡),21天内死亡人数增加了640例(14,569例死亡 vs. 13,929例死亡)。多变量分析显示,与紧邻的疫情前一年相比,疫情第一年接受紧急转运患者的死亡率增加(急诊科死亡的比值比为1.31;95%置信区间为1.26 - 1.38;21天内死亡的比值比为1.17;95%置信区间为1.14 - 1.20)。

结论

研究结果表明,COVID-19的传播影响了接受紧急转运患者的死亡率。预计进一步的研究将阐明COVID-19对紧急医疗系统的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4594/9830966/59c0452828ee/AMS2-10-e813-g001.jpg

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