Non-COVID Diseases during the Pandemic: Where Have All Other Emergencies Gone?
Non-COVID Diseases during the Pandemic: Where Have All Other Emergencies Gone?
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DOI：
10.3390/medicina56100512
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发表时间：
2020-10-01
期刊：
影响因子：
--
通讯作者：
Franceschi F
中科院分区：
文献类型：
--
作者：
Ojetti V;Covino M;Brigida M;Petruzziello C;Saviano A;Migneco A;Candelli M;Franceschi F
背景和目的：急诊科经常被患者认为是解决所有医疗问题的可能解决方案，导致误用急诊科的比率很高，可能导致过度拥挤。冠状病毒病2019年(新冠肺炎)大流行始于中国；然后蔓延到整个意大利，2020年2月在意大利伦巴第确诊首例病例。这完全改变了转诊到急诊室的患者类型。这项研究的目的是分析在新冠肺炎大流行期间，二级城市教学(Fondazione Policlinico University Agostino Gemelli IRCCS)的ED招生减少的情况。材料和方法：在这项回顾性观察性横断面研究中，我们回顾和比较了最近三年(2018-2019-2020)连续40天(2月21日-3月31日)在我们的ED住院的所有患者的临床记录。根据不同的医学专科、住院时间和出院率，分析平均年龄、性别、急诊程度、日夜入院时间、主要表现症状和最终诊断。结果：我们分析了16,281例患者的临床记录。与2019年相比，2020年急诊科的整体入学人数减少了37.6%。在2020年，我们观察到急诊急诊入院的急诊水平增加(主要表现症状是发烧)。我们注意到心胸、胃肠、泌尿外科、耳鼻喉科/眼科和创伤科疾病的入院人数显著下降。急性神经系统疾病仅有轻微但显著的减少。肿瘤科的入院人数稳定。2020年传染病入院人数为30%，而2018年和2019年分别为5%和6%。2020年住院率从27.7%上升到42.9%，前几年为26.4%。结论：在大流行期间急诊室入院人数的急剧减少可能与对病毒的恐惧有关，这表明患有严重疾病的患者没有去急诊室。此外，教育署在上一年亦可能被滥用。特别是，出现了关于心脏科和神经科入院人数下降的令人担忧的数据。这些患者推迟就医，可能会造成致命的后果，只是因为担心接触新冠肺炎，导致不必要的发病率和死亡率。
Background and objectives: the emergency department (ED) is frequently identified by patients as a possible solution for all healthcare problems, leading to a high rate of misuse of the ED, possibly causing overcrowding. The coronavirus disease 2019 (COVID-19) pandemic started in China; it then spread throughout Italy, with the first cases confirmed in Lombardy, Italy, in February 2020. This has totally changed the type of patients referred to EDs. The aim of this study was to analyze the reduction of ED admissions at a Second level urban teaching (Fondazione Policlinico Universitario Agostino Gemelli IRCCS) during the COVID-19 pandemic. Materials and Methods: in this retrospective observational cross-sectional study, we reviewed and compared clinical records of all the patients consecutively admitted to our ED over a 40-day period (21 February –31 March) in the last three years (2018–2019–2020). Mean age, sex, triage urgency level, day/night admission, main presentation symptom, and final diagnosis, according to different medical specialties, hospitalization, and discharge rate, were analyzed. Results: we analyzed 16,281 patient clinical records. The overall reduction in ED admissions in 2020 was 37.6% compared to 2019. In 2020, we observed an increase in triage urgency levels for ED admissions (the main presentation symptom was a fever). We noticed a significant drop in admissions for cardio-thoracic, gastroenterological, urological, otolaryngologic/ophthalmologic, and traumatological diseases. Acute neurological conditions registered only a slight, but significant, reduction. Oncology admissions were stable. Admissions for infectious diseases were 30% in 2020, compared to 5% and 6% in 2018 and 2019, respectively. In 2020, the hospitalization rate increased to 42.9% compared to 27.7%, and 26.4% in previous years. Conclusions: the drastic reduction of ED admissions during the pandemic may be associated with fear of the virus, suggesting that patients with serious illnesses did not go to the emergency room. Moreover, there was possible misuse of the ED in the previous year. In particular, worrisome data emerged regarding a drop in cardiology and neurology admissions. Those patients postponed medical attention, possibly with fatal consequences, just for fear of exposure to COVID-19, leading to unnecessary morbidity and mortality.
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影响因子：
15.1
作者：
Liu, Yang;Gu, Zhonglei;Liu, Jiming
通讯作者：
Liu, Jiming
影响因子：
2.1
作者：
Luciani, Lorenzo Giuseppe;Mattevi, Daniele;Malossini, Gianni
通讯作者：
Malossini, Gianni
影响因子：
1.7
作者：
Christiaens, Hanae;Charpentier, Sandrine;Balan, Frederic
通讯作者：
Balan, Frederic
影响因子：
14.2
作者：
Li, Xiaochen;Xu, Shuyun;Zhao, Jianping
通讯作者：
Zhao, Jianping
影响因子：
168.9
作者：
Mafham, Marion M.;Spata, Enti;Baigent, Colin
通讯作者：
Baigent, Colin