Kacerik Erika, Bottega Francesca, Andreassi Aida, Sechi Giuseppe, Zoli Alberto, Botteri Marco, Signorelli Carlo, Fagoni Nazzareno
Faculty of Medicine, School of Public Health, University of Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milano, Italy.
Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ), Via Campanini 6, 20124 Milano, Italy.
Epidemiologia (Basel). 2024 Jul 9;5(3):353-361. doi: 10.3390/epidemiologia5030025.
The COVID-19 pandemic strongly transformed the healthcare system in the Lombardy region (Italy), forcing a rapid reorganization of hospital structures. The emergency medical service (EMS) system and emergency departments (EDs) were among the most affected departments. Several studies have shown a change in the epidemiology of time-dependent pathologies, such as stroke, during the pandemic's peak. However, there is little scientific evidence regarding the interpandemic phase. The regional register for ED accesses (EUOL) was analyzed, taking into consideration all accesses for stroke and stroke-like syndromes during the years 2019, 2020, and 2021. The analysis shows a significant difference in the average number of diagnoses per month [2092 vs. 1815 vs. 2015, respectively ( < 0.05)] and an increase in the percentage of transports carried out by EMS vehicles to EDs [17% vs. 25% vs. 22%, respectively ( < 0.05)]. The length of stay (LOS) increased for both discharged patients (9.0 vs. 10.1 vs. 11.2 h, respectively; < 0.005) and hospitalized patients (7.5 vs. 9.7 vs. 10.6 h, respectively; < 0.005). During the COVID-19 pandemic, the overall number of stroke diagnoses decreased, while the percentage of patients transported to EDs by EMS vehicles increased. Furthermore, an increased processing time in EDs was highlighted.
新冠疫情极大地改变了意大利伦巴第地区的医疗体系，迫使医院结构迅速重组。紧急医疗服务（EMS）系统和急诊科是受影响最严重的部门之一。多项研究表明，在疫情高峰期，诸如中风等时间依赖性疾病的流行病学发生了变化。然而，关于疫情间歇期的科学证据却很少。我们分析了地区急诊科就诊登记册（EUOL），考虑了2019年、2020年和2021年期间所有中风及类似中风综合征的就诊情况。分析显示，每月平均诊断数量存在显著差异[分别为2092例、1815例和2015例（<0.05）]，且由EMS车辆送往急诊科的转运比例有所增加[分别为17%、25%和22%（<0.05）]。出院患者的住院时间（LOS）增加了（分别为9.0小时、10.1小时和11.2小时；<0.005），住院患者的住院时间也增加了（分别为7.5小时、9.7小时和10.6小时；<0.005）。在新冠疫情期间，中风诊断的总数有所下降，而由EMS车辆送往急诊科的患者比例有所增加。此外，还突出显示了急诊科处理时间的增加。
