Bottega Francesca, Kacerik Erika, Perotti Gabriele, Signorelli Carlo, Ristagno Giuseppe
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):362-370. doi: 10.3390/epidemiologia5030026.
The COVID-19 pandemic drastically reshaped healthcare in Lombardy, Italy, notably impacting EMS and emergency departments and altering the epidemiology of time-dependent pathologies such as STEMI and OHCA. While previous studies focused on modifications during the pandemic peak, with an increase in the number of OHCA diagnoses and a reduction in the number of STEMI, little evidence exists regarding the inter-pandemic phases. We analyzed OHCA and STEMI accesses to the ED in the regional emergency department access register (EUOL) for 2019-2021. The analysis revealed a significant difference in monthly diagnosis averages. For STEMI, the change was statistically significant (F(2, 33) = 4.45, = 0.02), while it was not for OHCA (F(2, 33) = 0.18, = 0.83). Despite the monthly decreases, the likelihood of receiving a STEMI diagnosis increased with total accesses, OR 1.40 [95% CI 1.25-1.58, < 0.0001]. Additionally, there was a significant increase in March 2020 discharge diagnoses for OHCA compared to March 2019, OR 3.35 [95% CI 2.88-3.90, < 0.0001], corresponding to the first pandemic wave. Therefore, our analysis indicates that the epidemiology of STEMI and OHCA was altered during the COVID-19 pandemic.
新冠疫情彻底重塑了意大利伦巴第大区的医疗体系，对紧急医疗服务（EMS）和急诊科产生了显著影响，并改变了诸如ST段抬高型心肌梗死（STEMI）和院外心脏骤停（OHCA）等时间依赖性疾病的流行病学特征。虽然此前的研究聚焦于疫情高峰期的变化，即OHCA诊断数量增加而STEMI数量减少，但关于疫情期间各阶段的证据却很少。我们分析了2019 - 2021年区域急诊科访问登记册（EUOL）中OHCA和STEMI患者前往急诊科就诊的情况。分析显示每月诊断平均值存在显著差异。对于STEMI，这种变化具有统计学意义（F(2, 33) = 4.45，P = 0.02），而OHCA则没有（F(2, 33) = 0.18，P = 0.83）。尽管每月有所下降，但STEMI诊断的可能性随总就诊次数增加，比值比（OR）为1.40 [95%置信区间（CI）1.25 - 1.58，P < 0.0001]。此外，与2019年3月相比，2020年3月OHCA出院诊断显著增加，OR为3.35 [95% CI 2.88 - 3.90，P < 0.0001]，这与第一波疫情相对应。因此，我们的分析表明，在新冠疫情期间STEMI和OHCA的流行病学特征发生了改变。
