Hospital admission and mortality rates for non-covid diseases in Denmark during covid-19 pandemic: nationwide population based cohort study.
Hospital admission and mortality rates for non-covid diseases in Denmark during covid-19 pandemic: nationwide population based cohort study.
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DOI：
10.1136/bmj.n1135
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发表时间：
2021-05-24
期刊：
影响因子：
--
通讯作者：
Skjøth F
中科院分区：
文献类型：
--
作者：
Bodilsen J;Nielsen PB;Søgaard M;Dalager-Pedersen M;Speiser LOZ;Yndigegn T;Nielsen H;Larsen TB;Skjøth F
确定2019冠状病毒病大流行期间非冠状病毒病医疗状况的住院发生率和相关死亡率。全国范围内，基于人群的队列研究。丹麦，2019年3月13日至2021年1月27日。所有丹麦居民>1岁。使用涵盖整个丹麦人口的基于人群的医疗保健登记系统，比较了2019冠状病毒病大流行期间（2020年3月11日至2021年1月27日）的住院率和死亡率与大流行前的基线数据（2019年3月13日至2020年3月10日）。当患者在入院后五天内被分配了新冠肺炎的诊断代码时，入院被归类为新冠肺炎。对所有患者进行随访，直至移位、死亡或随访结束，以先发生者为准。使用泊松回归计算住院率比，并使用2019年1月1日的丹麦人群作为参考直接标准化。通过考克斯回归分析30天死亡率比值，调整年龄和性别，并将COVID-19诊断用作竞争风险。在5.678亿人周的观察期间，确定了5 753 179名居民，675 447人中有1 113 705人入院。与大流行前基线期相比（平均住院率为204.1/100 000/周），非COVID-19疾病的总体住院率降至142.8/100 000/周（率比0.70，95%置信区间0.66至0.74）在第一次全国封锁后，随后逐渐恢复到基线水平，直到第二次全国封锁，当时下降到每100 000人/周158.3人（0.78，0.73至0.82）。这一模式反映在大多数主要诊断组中，但非新冠肺炎呼吸系统疾病、神经系统疾病、癌症、心力衰竭、脓毒症和非新冠肺炎呼吸道感染除外，这些疾病在整个研究期间保持较低水平。在第一次全国封锁期间（死亡率比1.28，95%置信区间1.23至1.32）和第二次全国封锁期间（1.20，1.16至1.24），总体30天死亡率较高，并且这些结果在大多数主要诊断组中相似。对于非COVID-19呼吸系统疾病、癌症、肺炎和败血症，封锁期间的30天死亡率比率也较高。与大流行前的基线期相比，在全国封锁期间，所有主要非COVID-19疾病组的住院人数都有所减少。此外，总体死亡率较高，因呼吸道疾病、癌症、肺炎和败血症等疾病住院的患者死亡率也较高。有必要加强对非新冠肺炎严重疾病管理的关注。
To determine the incidence of hospital admissions and associated mortality rates for non-covid medical conditions during the covid-19 pandemic. Nationwide, population based cohort study. Denmark from 13 March 2019 to 27 January 2021. All Danish residents >1 year of age. Population based healthcare registries that encompass the entire Danish population were used to compare hospital admission and mortality rates during the covid-19 pandemic (from 11 March 2020 to 27 January 2021) with the prepandemic baseline data (from 13 March 2019 to 10 March 2020). Hospital admissions were categorised as covid-19 when patients were assigned a diagnosis code for covid-19 within five days of admission. All patients were followed until migration, death, or end of follow-up, whichever came first. Rate ratios for hospital admissions were computed using Poisson regression and were directly standardised using the Danish population on 1 January 2019 as reference. 30 day mortality rate ratios were examined by Cox regression, adjusted for age and sex, and covid-19 diagnosis was used as a competing risk. 5 753 179 residents were identified during 567.8 million person weeks of observation, with 1 113 705 hospital admissions among 675 447 people. Compared with the prepandemic baseline period (mean hospital admission rate 204.1 per 100 000/week), the overall hospital admission rate for non-covid-19 conditions decreased to 142.8 per 100 000/week (rate ratio 0.70, 95% confidence interval 0.66 to 0.74) after the first national lockdown, followed by a gradual return to baseline levels until the second national lockdown when it decreased to 158.3 per 100 000/week (0.78, 0.73 to 0.82). This pattern was mirrored for most major diagnosis groups except for non-covid-19 respiratory diseases, nervous system diseases, cancer, heart failure, sepsis, and non-covid-19 respiratory infections, which remained lower throughout the study period. Overall 30 day mortality rates were higher during the first national lockdown (mortality rate ratio 1.28, 95% confidence interval 1.23 to 1.32) and the second national lockdown (1.20, 1.16 to 1.24), and these results were similar across most major diagnosis groups. For non-covid-19 respiratory diseases, cancer, pneumonia, and sepsis, the 30 day mortality rate ratios were also higher between lockdown periods. Hospital admissions for all major non-covid-19 disease groups decreased during national lockdowns compared with the prepandemic baseline period. Additionally, mortality rates were higher overall and for patients admitted to hospital with conditions such as respiratory diseases, cancer, pneumonia, and sepsis. Increased attention towards management of serious non-covid-19 medical conditions is warranted.
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影响因子：
39.3
作者：
De Rosa, Salvatore;Spaccarotella, Carmen;Indolfi, Ciro
通讯作者：
Indolfi, Ciro
DOI：
10.1016/j.amjmed.2020.08.043
发表时间：
2021-04
期刊：
The American journal of medicine
影响因子：
--
作者：
Sokolski M;Gajewski P;Zymliński R;Biegus J;Berg JMT;Bor W;Braunschweig F;Caldeira D;Cuculi F;D'Elia E;Edes IF;Garus M;Greenwood JP;Halfwerk FR;Hindricks G;Knuuti J;Kristensen SD;Landmesser U;Lund LH;Lyon A;Mebazaa A;Merkely B;Nawrocka-Millward S;Pinto FJ;Ruschitzka F;Semedo E;Senni M;Sepehri Shamloo A;Sorensen J;Stengaard C;Thiele H;Toggweiler S;Tukiendorf A;Verhorst PM;Wright DJ;Zamorano P;Zuber M;Narula J;Bax JJ;Ponikowski P
通讯作者：
Ponikowski P
影响因子：
3.9
作者：
Schmidt M;Schmidt SA;Sandegaard JL;Ehrenstein V;Pedersen L;Sørensen HT
通讯作者：
Sørensen HT
影响因子：
2.9
作者：
Lai AG;Pasea L;Banerjee A;Hall G;Denaxas S;Chang WH;Katsoulis M;Williams B;Pillay D;Noursadeghi M;Linch D;Hughes D;Forster MD;Turnbull C;Fitzpatrick NK;Boyd K;Foster GR;Enver T;Nafilyan V;Humberstone B;Neal RD;Cooper M;Jones M;Pritchard-Jones K;Sullivan R;Davie C;Lawler M;Hemingway H
通讯作者：
Hemingway H
影响因子：
168.9
作者：
Lee, Lennard Y. W.;Cazier, Jean Baptiste;Middleton, Gary
通讯作者：
Middleton, Gary