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COVID-19 疫情对台湾老年患者急诊科就诊的影响。

The impact of COVID-19 epidemic on emergency department visits of older patients in Taiwan.

机构信息

Department of Emergency Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei, 112, Taiwan.

Department of Emergency Medicine, Taoyuan Branch, Taipei Veterans General Hospital, Taoyuan, 330, Taiwan.

出版信息

BMC Geriatr. 2023 Aug 14;23(1):490. doi: 10.1186/s12877-023-04164-x.

Abstract

BACKGROUND

The number of emergency department (ED) visits has significantly declined since the COVID-19 pandemic. In Taiwan, an aged society, it is unknown whether older adults are accessing emergency care during the COVID-19 epidemic. Therefore, this study aimed to investigate the impact of COVID-19 on the ED visits and triage, admission, and intensive care unit (ICU) hospitalization of the geriatric population in a COVID-19-dedicated medical center throughout various periods of the epidemic.

METHODS

A retrospective chart review of ED medical records from April 9 to August 31, 2021 were conducted, and demographic information was obtained from the hospital's computer database. The period was divided into pre-, early-, peak-, late-, and post-epidemic stages. For statistical analysis, one-way analysis of variance followed by multiple comparison tests (Bonferroni correction) were used.

RESULTS

A statistically significant decrease in the total number of patients attending the ED was noted during the peak-, late-, and post-epidemic stages. In the post-epidemic stage, the number of older patients visiting ED was nearly to that of the pre-epidemic stage, indicating that older adults tend to seek care at the ED earlier than the general population. Throughout the entire epidemic period, there was no statistically significant reduction in the number of the triage 1& 2 patients seeking medical attention at the emergency department. In the entire duration of the epidemic, there was no observed reduction in the admission of elderly patients to our hospital or ICU through the ED. However, a statistically significant decrease was observed in the admission of the general population during the peak epidemic stage.

CONCLUSIONS

During the peak of COVID-19 outbreak, the number of ED visits was significantly affected. However, it is noteworthy that as the epidemic was gradually controlled, the older patients resumed their ED visits earlier that the general population as indicated by the surge in their number. Additionally, in the patient group of triage 1& 2, which represents a true emergency, the number did not show a drastic change.

摘要

背景

自 COVID-19 大流行以来,急诊科(ED)就诊人数显著下降。在台湾,人口老龄化严重,尚不清楚老年人在 COVID-19 流行期间是否会寻求急诊治疗。因此,本研究旨在调查 COVID-19 对一家 COVID-19 专用医疗中心老年人群的 ED 就诊、分诊、入院和重症监护病房(ICU)住院的影响,该研究贯穿了疫情的不同时期。

方法

回顾性分析 2021 年 4 月 9 日至 8 月 31 日期间 ED 病历的医疗记录,并从医院的计算机数据库中获取人口统计学信息。该时期分为流行前、早期、高峰期、后期和流行后阶段。统计分析采用单因素方差分析,然后进行多重比较检验(Bonferroni 校正)。

结果

高峰期、后期和流行后期 ED 就诊总人数呈显著下降趋势。在流行后期,就诊 ED 的老年患者人数几乎与流行前阶段相同,这表明老年人比一般人群更早地寻求 ED 治疗。在整个疫情期间,分诊 1&2 患者到 ED 就诊的人数没有明显减少。在整个疫情期间,没有观察到老年患者通过 ED 入院或转入 ICU 的人数减少。然而,在高峰期,普通人群的入院人数显著减少。

结论

在 COVID-19 爆发高峰期,ED 就诊人数受到显著影响。然而,值得注意的是,随着疫情逐渐得到控制,老年患者比一般人群更早地恢复了 ED 就诊,这表明他们的就诊人数有所增加。此外,在分诊 1&2 患者组,即真正的急诊患者,人数没有发生急剧变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e5/10424425/9e91d21f931b/12877_2023_4164_Fig1_HTML.jpg

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