Differential trends of admissions in accident and emergency departments during the COVID-19 pandemic in Germany.
Differential trends of admissions in accident and emergency departments during the COVID-19 pandemic in Germany.
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德国 COVID-19 大流行期间急症室入院的差异趋势。
DOI：
10.1186/s12873-021-00436-0
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发表时间：
2021-04-06
影响因子：
2.5
通讯作者：
Schreyer AG
中科院分区：
文献类型：
--
作者：
Jaehn P;Holmberg C;Uhlenbrock G;Pohl A;Finkenzeller T;Pawlik MT;Quack I;Ernstberger A;Rockmann F;Schreyer AG
最近的研究表明，在当地爆发COVID-19后，急诊室（A&E）的入院人数有所下降。然而，入院人数的不同趋势，例如根据诊断，还不太清楚。这一信息对于有针对性的干预至关重要。因此，我们的目的是根据人口统计学因素和诊断组，比较2020年3月12日前后和2019年德国急诊科的入院人数。2019年12月2日- 30.06.2020年至2018年12月1日- 30.06.2019年期间所有入院患者的常规数据来自德国西北部、东部、东南部和西南部五个城市的六家医院。我们使用ICD-10代码定义了10个诊断组：酒精所致精神障碍（MDA）、急性心肌梗死（AMI）、中风或短暂性脑缺血发作（TIA）、心力衰竭、肺炎、慢性阻塞性肺疾病（COPD）、胆石症或胆囊炎、背痛、前臂骨折和股骨骨折。我们计算了12.03.2020-30.06.2020与12.03.2019-30.06.2019不同时期的比率。在2020年3月12日至30.06.2020期间，共收治41353例病例，在2019年3月12日至30.06.2019期间收治51030例病例。12点03分之前入场。在2020年和2019年是相等的。在12点03分之后。与2019年相比，2020年的入学率下降幅度最大，为26.03人。和08.04。（- 30%， 95% CI - 33%至- 27%）。当分析整个时期12.03 -30.06。在美国，住院率的下降在各医院之间存在差异，0-17岁人群的下降幅度大于较大年龄组。在12.03后的前8周。除股骨骨折和肺炎外，所有诊断的入院人数均下降。在早期，因肺炎入院的人数有所增加。07.05之间。和2020年6月30日，我们注意到AMI （+ 13%， 95% CI - 3%至+ 32%）和胆石症或胆囊炎（+ 20%，95% CI + 1%至+ 44%）的入院率高于2019年。我们的研究结果表明，根据年龄、位置和诊断，住院人数的不同趋势。在德国，MDA、AMI、中风或TIA、心力衰竭、慢性阻塞性肺病、胆石症或胆囊炎和背痛的入院人数最初减少意味着急诊护理的延误。最后，我们的研究表明AMI合并胆石症或胆囊炎的入院率延迟增加。
Recent studies have shown a decrease of admissions to accident and emergency (A&E) departments after the local outbreaks of COVID-19. However, differential trends of admission counts, for example according to diagnosis, are less well understood. This information is crucial to inform targeted intervention. Therefore, we aimed to compare admission counts in German A&E departments before and after 12th march in 2020 with 2019 according to demographic factors and diagnosis groups. Routine data of all admissions between 02.12.2019–30.06.2020 and 01.12.2018–30.06.2019 was available from six hospitals in five cities from north-western, eastern, south-eastern, and south-western Germany. We defined 10 diagnosis groups using ICD-10 codes: mental disorders due to use of alcohol (MDA), acute myocardial infarction (AMI), stroke or transient ischemic attack (TIA), heart failure, pneumonia, chronic obstructive pulmonary disease (COPD), cholelithiasis or cholecystitis, back pain, fractures of the forearm, and fractures of the femur. We calculated rate ratios comparing different periods in 12.03.2020–30.06.2020 with 12.03.2019–30.06.2019. Forty-one thousand three hundred fifty-three cases were admitted between 12.03.2020–30.06.2020 and 51,030 cases between 12.03.2019–30.06.2019. Admission counts prior to 12.03. were equal in 2020 and 2019. In the period after 12.03., the decrease of admissions in 2020 compared to 2019 was largest between 26.03. and 08.04. (− 30%, 95% CI − 33% to − 27%). When analysing the entire period 12.03.-30.06., the decrease of admissions was heterogeneous among hospitals, and larger among people aged 0–17 years compared to older age groups. In the first 8 weeks after 12.03., admission counts of all diagnoses except femur fractures and pneumonia declined. Admissions with pneumonia increased in this early period. Between 07.05. and 30.6.2020, we noted that admissions with AMI (+ 13%, 95% CI − 3% to + 32%) and cholelithiasis or cholecystitis (+ 20%, 95% CI + 1% to + 44%) were higher than in 2019. Our results suggest differential trends of admission counts according to age, location, and diagnosis. An initial decrease of admissions with MDA, AMI, stroke or TIA, heart failure, COPD, cholelithiasis or cholecystitis, and back pain imply delays of emergency care in Germany. Finally, our study suggests a delayed increase of admissions with AMI and cholelithiasis or cholecystitis.
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2.1
作者：
Lange, Peter W.;Gazzard, Meg;Ward, Grantley A.
通讯作者：
Ward, Grantley A.
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168.9
作者：
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通讯作者：
Baigent, Colin