美国新冠疫情期间的心血管检测：检测量恢复情况及全球比较
Cardiovascular Testing in the United States during the COVID-19 Pandemic: Volume Recovery and Worldwide Comparison.
作者信息
Hirschfeld Cole B, Dorbala Sharmila, Shaw Leslee J, Villines Todd C, Choi Andrew D, Better Nathan, Cerci Rodrigo J, Karthikeyan Ganesan, Vitola João V, Williams Michelle C, Al-Mallah Mouaz, Berman Daniel S, Bernheim Adam, Biederman Robert W, Bravo Paco E, Budoff Matthew J, Bullock-Palmer Renee P, Chen Marcus Y, DiLorenzo Michael P, Doukky Rami, Ferencik Maros, Geske Jeffrey B, Hage Fadi G, Hendel Robert C, Koweek Lynne, Murthy Venkatesh L, Narula Jagat, Rodriguez Lozano Patricia F, Shah Nishant R, Shah Amee, Soman Prem, Thompson Randall C, Wolinsky David, Cohen Yosef A, Malkovskiy Eli, Randazzo Michael J, Lopez-Mattei Juan, Parwani Purvi, Shetty Mrinali, Pascual Thomas N B, Pynda Yaroslav, Dondi Maurizio, Paez Diana, Einstein Andrew J
机构信息
From the Division of Cardiology, Weill Cornell Medicine and NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, Mass (S.D.); Blavatnik Family Women's Health Research Institute, Mount Sinai Medical Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini Health, Royal Melbourne Hospital and University of Melbourne, Melbourne, Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C., J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.); Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.); Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ (R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY (M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.); Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of Cardiology, Deming Department of Medicine, Tulane University School of Medicine, New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.); Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department of Medicine, Cardiovascular Division, University of Virginia Health System, Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine, Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St Luke's Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology, Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of Cardiology, Columbia University Irving Medical Center and New York-Presbyterian Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.); Department of Medicine, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart & Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma Linda University Health, Loma Linda, Calif (P.P.); University of Chicago (NorthShore), NorthShore University Health System, Evanston, Ill (M.S.); Department of Science and Technology, Philippine Nuclear Research Institute, Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna, Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY (A.J.E.).
出版信息
Radiol Cardiothorac Imaging. 2023 Sep 21;5(5):e220288. doi: 10.1148/ryct.220288. eCollection 2023 Oct.
PURPOSE
To characterize the recovery of diagnostic cardiovascular procedure volumes in U.S. and non-U.S. facilities in the year following the initial COVID-19 outbreak.
MATERIALS AND METHODS
The International Atomic Energy Agency (IAEA) coordinated a worldwide study called the IAEA Noninvasive Cardiology Protocols Study of COVID-19 2 (INCAPS COVID 2), collecting data from 669 facilities in 107 countries, including 93 facilities in 34 U.S. states, to determine the impact of the pandemic on diagnostic cardiovascular procedure volumes. Participants reported volumes for each diagnostic imaging modality used at their facility for March 2019 (baseline), April 2020, and April 2021. This secondary analysis of INCAPS COVID 2 evaluated differences in changes in procedure volume between U.S. and non-U.S. facilities and among U.S. regions. Factors associated with return to prepandemic volumes in the United States were also analyzed in a multivariable regression analysis.
RESULTS
Reduction in procedure volumes in April 2020 compared with baseline was similar for U.S. and non-U.S. facilities (-66% vs -71%, = .27). U.S. facilities reported greater return to baseline in April 2021 than did all non-U.S. facilities (4% vs -6%, = .008), but there was no evidence of a difference when comparing U.S. facilities with non-U.S. high-income country (NUHIC) facilities (4% vs 0%, = .18). U.S. regional differences in return to baseline were observed between the Midwest (11%), Northeast (9%), South (1%), and West (-7%, = .03), but no studied factors were significant predictors of 2021 change from prepandemic baseline.
CONCLUSION
The reductions in cardiac testing during the early pandemic have recovered within a year to prepandemic baselines in the United States and NUHICs, while procedure volumes remain depressed in lower-income countries. SPECT, Cardiac, Epidemiology, Angiography, CT Angiography, CT, Echocardiography, SPECT/CT, MR Imaging, Radionuclide Studies, COVID-19, Cardiovascular Imaging, Diagnostic Cardiovascular Procedure, Cardiovascular Disease, Cardiac Testing © RSNA, 2023.
目的
描述美国和其他国家医疗机构在首次出现新冠疫情后的一年中诊断性心血管检查量的恢复情况。
材料与方法
国际原子能机构（IAEA）协调开展了一项名为国际原子能机构新冠疫情2期无创心脏病学协议研究（INCAPS COVID 2）的全球研究，收集了107个国家669家医疗机构的数据，其中包括美国34个州的93家医疗机构，以确定疫情对诊断性心血管检查量的影响。参与者报告了其机构在2019年3月（基线）、2020年4月和2021年4月使用的每种诊断成像方式的检查量。对INCAPS COVID 2的这项二次分析评估了美国和其他国家医疗机构以及美国各地区之间检查量变化的差异。还通过多变量回归分析研究了与美国恢复到疫情前检查量相关的因素。
结果
与基线相比，2020年4月美国和其他国家医疗机构的检查量减少情况相似（-66%对-71%，P = 0.27）。2021年4月，美国医疗机构报告的恢复到基线水平的情况优于所有其他国家的医疗机构（4%对-6%，P = 0.008），但将美国医疗机构与其他高收入国家（NUHIC）的医疗机构进行比较时，没有证据表明存在差异（4%对0%，P = 0.18）。在美国各地区，中西部（11%）、东北部（9%）、南部（1%）和西部（-7%，P = 0.03）恢复到基线水平存在差异，但所研究的因素均不是2021年相对于疫情前基线变化的显著预测因素。
结论
疫情初期心脏检查量的减少在美国和其他高收入国家已在一年内恢复到疫情前的基线水平，而低收入国家的检查量仍处于较低水平。SPECT、心脏、流行病学、血管造影、CT血管造影、CT、超声心动图、SPECT/CT、磁共振成像、放射性核素研究、新冠病毒、心血管成像、诊断性心血管检查、心血管疾病、心脏检查 © RSNA，2023年。
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