重塑急诊护理:OHCA 和 STEMI 三年动态分析

Francesca Bottega, E. Kacerik, Gabriele Perotti, Carlo Signorelli, G. Ristagno
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引用次数: 0

摘要

COVID-19 大流行彻底改变了意大利伦巴第大区的医疗保健状况,特别是影响了急救服务和急诊科,并改变了 STEMI 和 OHCA 等随时间变化的病症的流行病学。以前的研究主要关注大流行高峰期的变化,即 OHCA 诊断数量增加和 STEMI 诊断数量减少,但关于大流行间歇期的证据却很少。我们分析了 2019-2021 年地区急诊科就诊登记册(EUOL)中急诊科的 OHCA 和 STEMI 就诊情况。分析结果显示,每月的诊断平均值存在明显差异。就 STEMI 而言,这一变化具有统计学意义(F(2, 33) = 4.45, p = 0.02),而就 OHCA 而言,这一变化不具有统计学意义(F(2, 33) = 0.18, p = 0.83)。尽管每月都在减少,但随着总接入次数的增加,STEMI 诊断的可能性也在增加,OR 为 1.40 [95% CI 1.25-1.58,p < 0.0001]。此外,与 2019 年 3 月相比,2020 年 3 月出院诊断为 OHCA 的人数显著增加,OR 为 3.35 [95% CI 2.88-3.90,p <0.0001],与第一波大流行相对应。因此,我们的分析表明,在 COVID-19 大流行期间,STEMI 和 OHCA 的流行病学发生了变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reshaping Emergency Care: Dynamics of OHCA and STEMI in a Three-Year Analysis
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, p = 0.02), while it was not for OHCA (F(2, 33) = 0.18, p = 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, p < 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, p < 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.
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