Emergency Department Utilization and Patient Outcomes During the COVID-19 Pandemic in America.
Emergency Department Utilization and Patient Outcomes During the COVID-19 Pandemic in America.
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DOI：
10.1016/j.jemermed.2021.01.002
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Johnson D
中科院分区：
文献类型：
--
作者：
Gutovitz S;Pangia J;Finer A;Rymer K;Johnson D
2019年冠状病毒病（COVID-19）大流行加剧了对传染病的恐惧，并影响了许多人避免急诊（艾德）。目前尚不清楚这种避免是否影响整体健康或疾病死亡率。我们的目的是量化美国艾德的减少量，确定它是否在全国范围内同时发生，发现哪些类型的患者减少，并测量患者结局的变化。我们回顾性地访问了由HCA Healthcare管理的多医院、多州电子健康记录数据库，以获得2019冠状病毒病大流行早期（2020年3月1日至5月31日）和2019年相同日期期间所有就诊于艾德的患者的病例系列，以进行比较。我们使用每周总量确定艾德体积，并按州进行分组。我们还记录了最终诊断代码和死亡率数据，以描述患者类型和结局。来自160家机构的每周艾德量从141，408例患者（第1周，2020年3月1日至7日）下降44%至79，618例患者的最低点（第7周，2020年4月12日至18日），然后回升至105，667例（第13周，2020年5月24日至30日）。与2019年相比，这一总体降幅具有统计学意义（p < 0.001）。除传染病和呼吸道疾病有所增加外，其他疾病类别的下降是普遍的。在大流行期间，全因死亡率增加，特别是那些患有传染病、循环系统和呼吸系统疾病的人。COVID-19大流行和对传染的明显恐惧导致我们医院系统的艾德就诊减少。艾德体积的减少与艾德死亡率的增加相关，这可能是由于延迟的艾德表现。
The coronavirus disease 2019 (COVID-19) pandemic precipitated fear of contagion and influenced many people to avoid the emergency department (ED). It is unknown if this avoidance effected overall health or disease mortality. We aimed to quantify the decreased ED volume in the United States, determine whether it occurred simultaneously across the country, find which types of patients decreased, and measure resultant changes in patient outcomes. We retrospectively accessed a multihospital, multistate electronic health records database managed by HCA Healthcare to obtain a case series of all patients presenting to an ED during the early COVID-19 pandemic (March 1–May 31, 2020) and the same dates in 2019 for comparison. We determined ED volume using weekly totals and grouped them by state. We also recorded final diagnoses codes and mortality data to describe patient types and outcomes. The weekly ED volume from 160 facilities dropped 44% from 141,408 patients (week 1, March 1–7, 2020) to a nadir of 79,618 patients (week 7, April 12–18, 2020), before rising back to 105,667 (week 13, May 24–30, 2020). Compared with 2019, this overall decline was statistically significant (p < 0.001). The decline was universal across disease categories except for infectious disease and respiratory illnesses, which increased. All-cause mortality increased during the pandemic, especially for those with infectious disease, circulatory, and respiratory illnesses. The COVID-19 pandemic and an apparent fear of contagion caused a decrease in ED presentations across our hospital system. The decline in ED volume was associated with increased ED mortality, perhaps from delayed ED presentations.
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影响因子：
4.2
作者：
Martin, L. J.;Dong, H.;Yasui, Y.
通讯作者：
Yasui, Y.
DOI：
10.1111/acem.12111
发表时间：
2013-04
期刊：
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
影响因子：
--
作者：
Schanzer DL;Schwartz B
通讯作者：
Schwartz B
影响因子：
2.4
作者：
Hall, Geoffrey G.;Perry, Alexander G.;Moore, Kieran M.
通讯作者：
Moore, Kieran M.
影响因子：
8.3
作者：
Teo, Kay-Cheong;Leung, William C. Y.;Lau, Kui Kai
通讯作者：
Lau, Kui Kai
影响因子：
4.4
作者：
Filice, Clara E.;Vaca, Federico E.;Bogucki, Sandy
通讯作者：
Bogucki, Sandy