Fewer Hospitalizations for Acute Cardiovascular Conditions During the COVID-19 Pandemic
Fewer Hospitalizations for Acute Cardiovascular Conditions During the COVID-19 Pandemic
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DOI：
10.1016/j.jacc.2020.05.038
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发表时间：
2020-07-21
影响因子：
24
通讯作者：
Vaduganathan, Muthiah
中科院分区：
文献类型：
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作者：
Bhatt, Ankeet S.;Moscone, Alea;Vaduganathan, Muthiah
背景：尽管心血管疾病患者面临2019年冠状病毒病严重疾病的超额风险(新冠肺炎)，但大流行可能会对这一高危患者群体产生间接后果。目的本研究旨在研究三级医疗卫生系统中急性心血管疾病住院治疗的纵向趋势。方法跟踪2019年1月1日至2020年3月31日期间的急性心血管住院情况。使用负二项模型估计每日住院率。比较了2020年前3个月住院率的时间趋势，并以2019年前3个月为参考。结果从2019年1月1日至2020年3月31日，6083名患者因主要急性心血管原因住院7187次。与2019年3月相比，2020年3月的估计日住院率减少了43.4%(95%可信区间：27.4%至56.0%)(p<；0.001)。每日住院率在2019年期间没有变化(-0.01%/天[95%CI：-0.04%至+0.02%]；p=0.50)、2020年1月(-0.5%/天[95%CI：-1.6%至+0.5%]；p=0.31)或2020年2月(+0.7%/天[95%CI：-0.6%至+2.0%]；p=0.27)。2020年3月，住院人数每天显著下降(-5.9%/天[95%CI：-7.6%至-4.3%]；p<；0.001)。与2019年3月相比，2020年3月的住院时间缩短了4.8d[第25至第75个百分位数：2.4至8.3d]vs.6.0天[第25至75%：3.1至9.6d；p=0.003]，住院死亡率没有显著差异(6.2%vs.4.4%；p=0.3)。结论在新冠肺炎大流行的第一阶段，急性心血管疾病住院人数明显下降，住院患者的住院时间较短。这些数据证实了人们的担忧，即在新冠肺炎大流行期间，心血管疾病的急性护理可能会被推迟、推迟或缩短。(C)2020年，由美国心脏病学会基金会提供。
BACKGROUND Although patients with cardiovascular disease face excess risks of severe illness with coronavirus disease-2019 (COVID-19), there may be indirect consequences of the pandemic on this high-risk patient segment. OBJECTIVES This study sought to examine longitudinal trends in hospitalizations for acute cardiovascular conditions across a tertiary care health system. METHODS Acute cardiovascular hospitalizations were tracked between January 1, 2019, and March 31, 2020. Daily hospitalization rates were estimated using negative binomial models. Temporal trends in hospitalization rates were compared across the first 3 months of 2020, with the first 3 months of 2019 as a reference. RESULTS From January 1, 2019, to March 31, 2020, 6,083 patients experienced 7,187 hospitalizations for primary acute cardiovascular reasons. There were 43.4% (95% confidence interval [CI]: 27.4% to 56.0%) fewer estimated daily hospitalizations in March 2020 compared with March 2019 (p < 0.001). The daily rate of hospitalizations did not change throughout 2019 (-0.01% per day [95% CI: -0.04% to +0.02%]; p = 0.50), January 2020 (-0.5% per day [95% CI: -1.6% to +0.5%]; p = 0.31), or February 2020 (+0.7% per day [95% CI: -0.6% to +2.0%]; p = 0.27). There was significant daily decline in hospitalizations in March 2020 (-5.9% per day [95% CI: -7.6% to -4.3%]; p < 0.001). Length of stay was shorter (4.8 days [25th to 75th percentiles: 2.4 to 8.3 days] vs. 6.0 days [25th to 75th percentiles: 3.1 to 9.6 days]; p = 0.003) and in-hospital mortality was not significantly different (6.2% vs. 4.4%; p = 0.30) in March 2020 compared with March 2019. CONCLUSIONS During the first phase of the COVID-19 pandemic, there was a marked decline in acute cardiovascular hospitalizations, and patients who were admitted had shorter lengths of stay. These data substantiate concerns that acute care of cardiovascular conditions may be delayed, deferred, or abbreviated during the COVID-19 pandemic. (c) 2020 by the American College of Cardiology Foundation.