Substantial decline in hospital admissions for heart failure accompanied by increased community mortality during COVID-19 pandemic.
Substantial decline in hospital admissions for heart failure accompanied by increased community mortality during COVID-19 pandemic.
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DOI：
10.1093/ehjqcco/qcab040
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发表时间：
2021-07-21
期刊：
影响因子：
--
通讯作者：
Mamas MA
中科院分区：
文献类型：
--
作者：
Shoaib A;Van Spall HGC;Wu J;Cleland JGF;McDonagh TA;Rashid M;Mohamed MO;Ahmed FZ;Deanfield J;de Belder M;Gale CP;Mamas MA
我们假设，在新冠肺炎大流行期间，心力衰竭患者入院人数的下降将导致社区心力衰竭患者死亡率的对等上升。我们使用国家心力衰竭审计的数据来识别36 974名成年人，他们在2018年、2019年或2020年2月至5月期间入院，初步诊断为心力衰竭。2018/19年因心力衰竭入院的平均人数为160日/日，但2020年的住院率要低得多，在2020年3月27日达到/日的最低点[发病率比：0.40，95%可信区间：0.38-0.42]。2018/19年指南建议的药物疗法的出院比例与2020年同期相似。在2020年2月1日至2020年5月31日期间，与心力衰竭有关的住院死亡人数下降了29%(IRR：0.71，95%CI：0.67-0.75；估计下降了448人)，在家中死于心力衰竭的人数增加了31%(IRR：1.31，95%CI：1.24-1.39；估计超过539人)，在疗养院和临终关怀机构的心力衰竭死亡人数增加了28%(IRR：1.28，95%CI：1.18-1.40；估计超过189人)。新冠肺炎期间和新冠肺炎前的全原因住院死亡率相似[优势比(OR)：1.02，95%CI：0.94-1.10]。出院后，2020年的30天死亡率高于2018/19年(OR：1.57，95%CI：1.38-1.78)。与2018/19年的滚动日均相比，社区中因心力衰竭入院的人数大幅下降，但死于心力衰竭的人数有所增加。尽管指南推荐治疗的处方率相似，但在新冠肺炎大流行期间，出院30天内的死亡率更高。
We hypothesized that a decline in admissions with heart failure during COVID-19 pandemic would lead to a reciprocal rise in mortality for patients with heart failure in the community. We used National Heart Failure Audit data to identify 36 974 adults who had a hospital admission with a primary diagnosis of heart failure between February and May in either 2018, 2019, or 2020. Hospital admissions for heart failure in 2018/19 averaged 160/day but were much lower in 2020, reaching a nadir of 64/day on 27 March 2020 [incidence rate ratio (IRR): 0.40, 95% confidence interval (CI): 0.38–0.42]. The proportion discharged on guideline-recommended pharmacotherapies was similar in 2018/19 compared to the same period in 2020. Between 1 February–2020 and 31 May 2020, there was a 29% decrease in hospital deaths related to heart failure (IRR: 0.71, 95% CI: 0.67–0.75; estimated decline of 448 deaths), a 31% increase in heart failure deaths at home (IRR: 1.31, 95% CI: 1.24–1.39; estimated excess 539), and a 28% increase in heart failure deaths in care homes and hospices (IRR: 1.28, 95% CI: 1.18–1.40; estimated excess 189). All-cause, inpatient death was similar in the COVID-19 and pre-COVID-19 periods [odds ratio (OR): 1.02, 95% CI: 0.94–1.10]. After hospital discharge, 30-day mortality was higher in 2020 compared to 2018/19 (OR: 1.57, 95% CI: 1.38–1.78). Compared with the rolling daily average in 2018/19, there was a substantial decline in admissions for heart failure but an increase in deaths from heart failure in the community. Despite similar rates of prescription of guideline-recommended therapy, mortality 30 days from discharge was higher during the COVID-19 pandemic period.
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影响因子：
18.2
作者：
Koudstaal, Stefan;Pujades-Rodriguez, Mar;Hemingway, Harry
通讯作者：
Hemingway, Harry
影响因子：
5.7
作者：
Brant, Luisa Campos Caldeira;Nascimento, Bruno Ramos;Ribeiro, Antonio Luiz Pinho
通讯作者：
Ribeiro, Antonio Luiz Pinho
影响因子：
9.7
作者：
Andersson, Charlotte;Gerds, Thomas;Schou, Morten
通讯作者：
Schou, Morten
监测 COVID-19 大流行对英国心血管疾病服务的间接影响。
DOI：
10.1136/heartjnl-2020-317870
发表时间：
2020-12
期刊：
Heart (British Cardiac Society)
影响因子：
--
作者：
Ball S;Banerjee A;Berry C;Boyle JR;Bray B;Bradlow W;Chaudhry A;Crawley R;Danesh J;Denniston A;Falter F;Figueroa JD;Hall C;Hemingway H;Jefferson E;Johnson T;King G;Lee KK;McKean P;Mason S;Mills NL;Pearson E;Pirmohamed M;Poon MTC;Priedon R;Shah A;Sofat R;Sterne JAC;Strachan FE;Sudlow CLM;Szarka Z;Whiteley W;Wyatt M;CVD-COVID-UK Consortium
通讯作者：
CVD-COVID-UK Consortium
影响因子：
5.6
作者：
Ogunleye OO;Basu D;Mueller D;Sneddon J;Seaton RA;Yinka-Ogunleye AF;Wamboga J;Miljković N;Mwita JC;Rwegerera GM;Massele A;Patrick O;Niba LL;Nsaikila M;Rashed WM;Hussein MA;Hegazy R;Amu AA;Boahen-Boaten BB;Matsebula Z;Gwebu P;Chirigo B;Mkhabela N;Dlamini T;Sithole S;Malaza S;Dlamini S;Afriyie D;Asare GA;Amponsah SK;Sefah I;Oluka M;Guantai AN;Opanga SA;Sarele TV;Mafisa RK;Chikowe I;Khuluza F;Kibuule D;Kalemeera F;Mubita M;Fadare J;Sibomana L;Ramokgopa GM;Whyte C;Maimela T;Hugo J;Meyer JC;Schellack N;Rampamba EM;Visser A;Alfadl A;Malik EM;Malande OO;Kalungia AC;Mwila C;Zaranyika T;Chaibva BV;Olaru ID;Masuka N;Wale J;Hwenda L;Kamoga R;Hill R;Barbui C;Bochenek T;Kurdi A;Campbell S;Martin AP;Phuong TNT;Thanh BN;Godman B
通讯作者：
Godman B