Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19.
Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19.
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DOI：
10.1016/j.jacc.2022.03.348
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发表时间：
2022-05-24
影响因子：
24
通讯作者：
Paez, Diana
中科院分区：
文献类型：
--
作者：
Einstein, Andrew J.;Hirschfeld, Cole;Williams, Michelle C.;Vitola, Joao V.;Better, Nathan;Villines, Todd C.;Cerci, Rodrigo;Shaw, Leslee J.;Choi, Andrew D.;Dorbala, Sharmila;Karthikeyan, Ganesan;Lu, Bin;Sinitsyn, Valentin;Ansheles, Alexey A.;Kudo, Takashi;Bucciarelli-Ducci, Chiara;Norgaard, Bjarne Linde;Maurovich-Horvat, Pal;Campisi, Roxana;Milan, Elisa;Louw, Lizette;Allam, Adel H.;Bhatia, Mona;Sewanan, Lorenzo;Malkovskiy, Eli;Cohen, Yosef;Randazzo, Michael;Narula, Jagat;Morozova, Olga;Pascual, Thomas N. B.;Pynda, Yaroslav;Dondi, Maurizio;Paez, Diana
卫生保健系统在多大程度上适应了COVID-19大流行，以提供必要的心脏诊断服务尚不清楚。这项研究的目的是确定大流行对心脏检测实践、诊断服务的数量和类型以及全球卫生保健提供者感知的心理压力的影响。国际原子能机构进行了一项全球调查，评估在大流行开始时和一年后心血管诊断护理与基线相比的变化。使用多变量回归确定与手术容量恢复相关的因素。来自107个国家的669个中心提交了调查。从2019年3月至2020年4月，全球心脏手术量减少64%，到2021年4月，高收入和中高收入国家恢复（恢复率分别为108%和99%），但中低收入和低收入国家仍然低迷（恢复率分别为46%和30%）。尽管2021年压力测试的使用频率比2019年减少了12%，但冠状动脉计算机断层扫描血管造影的使用频率增加了14%，这一趋势也见于其他先进的心脏成像方式（正电子发射断层扫描和磁共振;增加22%-25%）。据估计，与流行病相关的心理压力影响了近40%的工作人员，影响了78%的地点的病人护理。在多元回归分析中，只有低收入状况和医生的心理压力对心脏检查恢复有显著预测作用。在低收入国家，心脏诊断检测尚未恢复到大流行前的水平。在世界范围内，标准压力测试的减少被先进心脏成像模式的更多使用所抵消。提供者普遍存在与流行病相关的心理压力，并与心脏测试恢复不良有关。
The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown. The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide. The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic’s onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery. Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians’ psychological stress were significant in predicting recovery of cardiac testing. Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing.
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影响因子：
15.1
作者：
Prasad K;McLoughlin C;Stillman M;Poplau S;Goelz E;Taylor S;Nankivil N;Brown R;Linzer M;Cappelucci K;Barbouche M;Sinsky CA
通讯作者：
Sinsky CA
DOI：
10.1016/s2213-2600(21)00068-0
发表时间：
2021-03
期刊：
The Lancet. Respiratory medicine
影响因子：
--
作者：
Mehta S;Machado F;Kwizera A;Papazian L;Moss M;Azoulay É;Herridge M
通讯作者：
Herridge M
影响因子：
24
作者：
Einstein AJ;Shaw LJ;Hirschfeld C;Williams MC;Villines TC;Better N;Vitola JV;Cerci R;Dorbala S;Raggi P;Choi AD;Lu B;Sinitsyn V;Sergienko V;Kudo T;Nørgaard BL;Maurovich-Horvat P;Campisi R;Milan E;Louw L;Allam AH;Bhatia M;Malkovskiy E;Goebel B;Cohen Y;Randazzo M;Narula J;Pascual TNB;Pynda Y;Dondi M;Paez D;the;INCAPS COVID Investigators Group
通讯作者：
INCAPS COVID Investigators Group
影响因子：
29.9
作者：
Josephson, Anna;Kilic, Talip;Michler, Jeffrey D.
通讯作者：
Michler, Jeffrey D.
影响因子：
24
作者：
Hlatky, Mark A.;Shilane, David;DiCarli, Marcelo F.
通讯作者：
DiCarli, Marcelo F.