The mystery of "missing" visits in an emergency cardiology department, in the era of COVID-19.; a time-series analysis in a tertiary Greek General Hospital.
Identifieur interne : 000045 ( Main/Exploration ); précédent : 000044; suivant : 000046The mystery of "missing" visits in an emergency cardiology department, in the era of COVID-19.; a time-series analysis in a tertiary Greek General Hospital.
Auteurs : Konstantinos Tsioufis [Grèce] ; Christina Chrysohoou [Grèce] ; Maria Kariori [Grèce] ; Ioannis Leontsinis [Grèce] ; Ioannis Dalakouras [Grèce] ; Angelos Papanikolaou [Grèce] ; Georgios Charalambus [Grèce] ; Helen Sambatakou [Grèce] ; Gerasimos Siassos [Grèce] ; Demosthenes Panagiotakos [Grèce] ; Dimitrios Tousoulis [Grèce]Source :
- Clinical research in cardiology : official journal of the German Cardiac Society [ 1861-0692 ] ; 2020.
Abstract
BACKGROUND
In the era of the current COVID-19 health crisis, the aim of the present study was to explore population behavior as regards the visits in the Εmergency Cardiology department (ECD) of a tertiary General Hospital that does not hospitalize SARS-CoV-2 infected patients METHODS AND RESULTS: Daily number of visits at the EDC and admissions to Cardiology Wards and Intensive Care Unit of a tertiary General Hospital, in Athens, Greece, were retrieved from hospital's database (January 1st-April 30th 2018, 2019 and 2020). A highly significant reduction in the visits at ECD of the hospital during March and April 2020 was observed as compared with January and February of the same year (p for linear trend < ·001); in particular the number of visits was 41.1% lower in March 2020 and 32.7% lower in April 2020, as compared to January 2020. As the number of confirmed COVID-19 cases throughout the country increased (i.e., from February 26th to April 2nd) the number of visits at ECD decreased (p = 0.01), whereas, the opposite was observed in the period afterwards (p = 0.01).The number of acute Myocardial infarctions (MI) cases in March 2020 was the lowest compared to the entire three year period (p < 0·001); however, the number of acute MI cases in April 2020 was doubled as compared to March 2020, but still was lower than the preceding years (p < 0·001).
CONCLUSIONS
It is hard to explain the mystery of the "missing" emergency hospital visits. However, if this decline in cardiovascular disease related hospital visits is "true", it is something that needs to be rigorously studied, to learn how to keep these rates down.
DOI: 10.1007/s00392-020-01682-1
PubMed: 32506198
PubMed Central: PMC7275652
Affiliations:
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emergency cardiology department, in the era of COVID-19.; a time-series analysis in a tertiary Greek General Hospital.</title><author><name sortKey="Tsioufis, Konstantinos" sort="Tsioufis, Konstantinos" uniqKey="Tsioufis K" first="Konstantinos" last="Tsioufis">Konstantinos Tsioufis</name><affiliation wicri:level="3"><nlm:affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece. ktsioufis@hippocratio.gr.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens</wicri:regionArea><placeName><settlement type="city">Athènes</settlement><region nuts="2" type="region">Attique (région)</region></placeName></affiliation></author><author><name sortKey="Chrysohoou, Christina" sort="Chrysohoou, Christina" uniqKey="Chrysohoou C" first="Christina" last="Chrysohoou">Christina Chrysohoou</name><affiliation wicri:level="3"><nlm:affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens</wicri:regionArea><placeName><settlement type="city">Athènes</settlement><region nuts="2" type="region">Attique (région)</region></placeName></affiliation></author><author><name sortKey="Kariori, Maria" sort="Kariori, Maria" uniqKey="Kariori M" first="Maria" last="Kariori">Maria Kariori</name><affiliation wicri:level="3"><nlm:affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens</wicri:regionArea><placeName><settlement type="city">Athènes</settlement><region nuts="2" type="region">Attique (région)</region></placeName></affiliation></author><author><name sortKey="Leontsinis, Ioannis" sort="Leontsinis, Ioannis" uniqKey="Leontsinis I" first="Ioannis" last="Leontsinis">Ioannis Leontsinis</name><affiliation wicri:level="3"><nlm:affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens</wicri:regionArea><placeName><settlement type="city">Athènes</settlement><region nuts="2" type="region">Attique (région)</region></placeName></affiliation></author><author><name sortKey="Dalakouras, Ioannis" sort="Dalakouras, Ioannis" uniqKey="Dalakouras I" first="Ioannis" last="Dalakouras">Ioannis Dalakouras</name><affiliation wicri:level="3"><nlm:affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens</wicri:regionArea><placeName><settlement type="city">Athènes</settlement><region nuts="2" type="region">Attique (région)</region></placeName></affiliation></author><author><name sortKey="Papanikolaou, Angelos" sort="Papanikolaou, Angelos" uniqKey="Papanikolaou A" first="Angelos" last="Papanikolaou">Angelos Papanikolaou</name><affiliation wicri:level="3"><nlm:affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens</wicri:regionArea><placeName><settlement type="city">Athènes</settlement><region nuts="2" type="region">Attique (région)</region></placeName></affiliation></author><author><name sortKey="Charalambus, Georgios" sort="Charalambus, Georgios" uniqKey="Charalambus G" first="Georgios" last="Charalambus">Georgios Charalambus</name><affiliation wicri:level="3"><nlm:affiliation>Emergency Department, Hippocratio Hospital, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>Emergency Department, Hippocratio Hospital, Athens</wicri:regionArea><placeName><settlement type="city">Athènes</settlement><region nuts="2" type="region">Attique (région)</region></placeName></affiliation></author><author><name sortKey="Sambatakou, Helen" sort="Sambatakou, Helen" uniqKey="Sambatakou H" first="Helen" last="Sambatakou">Helen Sambatakou</name><affiliation wicri:level="3"><nlm:affiliation>2nd Department of Internal Medicine, HIV Unit, Medical School, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>2nd Department of Internal Medicine, HIV Unit, Medical School, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens</wicri:regionArea><placeName><settlement type="city">Athènes</settlement><region nuts="2" type="region">Attique (région)</region></placeName></affiliation></author><author><name sortKey="Siassos, Gerasimos" sort="Siassos, Gerasimos" uniqKey="Siassos G" first="Gerasimos" last="Siassos">Gerasimos Siassos</name><affiliation wicri:level="3"><nlm:affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens</wicri:regionArea><placeName><settlement type="city">Athènes</settlement><region nuts="2" type="region">Attique (région)</region></placeName></affiliation></author><author><name sortKey="Panagiotakos, Demosthenes" sort="Panagiotakos, Demosthenes" uniqKey="Panagiotakos D" first="Demosthenes" last="Panagiotakos">Demosthenes Panagiotakos</name><affiliation wicri:level="4"><nlm:affiliation>School of Health Science and Education, Harokopio University, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>School of Health Science and Education, Harokopio University, Athens</wicri:regionArea><placeName><settlement type="city">Athènes</settlement><region nuts="2" type="region">Attique (région)</region></placeName><orgName type="university">Université Harokopio</orgName></affiliation></author><author><name sortKey="Tousoulis, Dimitrios" sort="Tousoulis, Dimitrios" uniqKey="Tousoulis D" first="Dimitrios" last="Tousoulis">Dimitrios Tousoulis</name><affiliation wicri:level="3"><nlm:affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens</wicri:regionArea><placeName><settlement type="city">Athènes</settlement><region nuts="2" type="region">Attique (région)</region></placeName></affiliation></author></analytic><series><title level="j">Clinical research in cardiology : official journal of the German Cardiac Society</title><idno type="eISSN">1861-0692</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>In the era of the current COVID-19 health crisis, the aim of the present study was to explore population behavior as regards the visits in the Εmergency Cardiology department (ECD) of a tertiary General Hospital that does not hospitalize SARS-CoV-2 infected patients METHODS AND RESULTS: Daily number of visits at the EDC and admissions to Cardiology Wards and Intensive Care Unit of a tertiary General Hospital, in Athens, Greece, were retrieved from hospital's database (January 1st-April 30th 2018, 2019 and 2020). A highly significant reduction in the visits at ECD of the hospital during March and April 2020 was observed as compared with January and February of the same year (p for linear trend < ·001); in particular the number of visits was 41.1% lower in March 2020 and 32.7% lower in April 2020, as compared to January 2020. As the number of confirmed COVID-19 cases throughout the country increased (i.e., from February 26th to April 2nd) the number of visits at ECD decreased (p = 0.01), whereas, the opposite was observed in the period afterwards (p = 0.01).The number of acute Myocardial infarctions (MI) cases in March 2020 was the lowest compared to the entire three year period (p < 0·001); however, the number of acute MI cases in April 2020 was doubled as compared to March 2020, but still was lower than the preceding years (p < 0·001).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>It is hard to explain the mystery of the "missing" emergency hospital visits. However, if this decline in cardiovascular disease related hospital visits is "true", it is something that needs to be rigorously studied, to learn how to keep these rates down.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32506198</PMID><DateRevised><Year>2020</Year><Month>06</Month><Day>11</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1861-0692</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Jun</Month><Day>06</Day></PubDate></JournalIssue><Title>Clinical research in cardiology : official journal of the German Cardiac Society</Title><ISOAbbreviation>Clin Res Cardiol</ISOAbbreviation></Journal><ArticleTitle>The mystery of "missing" visits in an emergency cardiology department, in the era of COVID-19.; a time-series analysis in a tertiary Greek General Hospital.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1007/s00392-020-01682-1</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">In the era of the current COVID-19 health crisis, the aim of the present study was to explore population behavior as regards the visits in the Εmergency Cardiology department (ECD) of a tertiary General Hospital that does not hospitalize SARS-CoV-2 infected patients METHODS AND RESULTS: Daily number of visits at the EDC and admissions to Cardiology Wards and Intensive Care Unit of a tertiary General Hospital, in Athens, Greece, were retrieved from hospital's database (January 1st-April 30th 2018, 2019 and 2020). A highly significant reduction in the visits at ECD of the hospital during March and April 2020 was observed as compared with January and February of the same year (p for linear trend < ·001); in particular the number of visits was 41.1% lower in March 2020 and 32.7% lower in April 2020, as compared to January 2020. As the number of confirmed COVID-19 cases throughout the country increased (i.e., from February 26th to April 2nd) the number of visits at ECD decreased (p = 0.01), whereas, the opposite was observed in the period afterwards (p = 0.01).The number of acute Myocardial infarctions (MI) cases in March 2020 was the lowest compared to the entire three year period (p < 0·001); however, the number of acute MI cases in April 2020 was doubled as compared to March 2020, but still was lower than the preceding years (p < 0·001).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">It is hard to explain the mystery of the "missing" emergency hospital visits. However, if this decline in cardiovascular disease related hospital visits is "true", it is something that needs to be rigorously studied, to learn how to keep these rates down.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Tsioufis</LastName><ForeName>Konstantinos</ForeName><Initials>K</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-7636-6725</Identifier><AffiliationInfo><Affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece. ktsioufis@hippocratio.gr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chrysohoou</LastName><ForeName>Christina</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kariori</LastName><ForeName>Maria</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Leontsinis</LastName><ForeName>Ioannis</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dalakouras</LastName><ForeName>Ioannis</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Papanikolaou</LastName><ForeName>Angelos</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Charalambus</LastName><ForeName>Georgios</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Emergency Department, Hippocratio Hospital, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sambatakou</LastName><ForeName>Helen</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>2nd Department of Internal Medicine, HIV Unit, Medical School, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Siassos</LastName><ForeName>Gerasimos</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Panagiotakos</LastName><ForeName>Demosthenes</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>School of Health Science and Education, Harokopio University, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tousoulis</LastName><ForeName>Dimitrios</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vass Sofias Ave, 11527, Athens, Greece.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Clin Res Cardiol</MedlineTA><NlmUniqueID>101264123</NlmUniqueID><ISSNLinking>1861-0684</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Covid19</Keyword><Keyword MajorTopicYN="N">Emergency cardiological department</Keyword><Keyword MajorTopicYN="N">Missing visits</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>05</Month><Day>04</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>05</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>6</Month><Day>8</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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IdType="pubmed">30989318</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Grèce</li></country><region><li>Attique (région)</li></region><settlement><li>Athènes</li></settlement><orgName><li>Université Harokopio</li></orgName></list><tree><country name="Grèce"><region name="Attique (région)"><name sortKey="Tsioufis, Konstantinos" sort="Tsioufis, Konstantinos" uniqKey="Tsioufis K" first="Konstantinos" last="Tsioufis">Konstantinos Tsioufis</name></region><name sortKey="Charalambus, Georgios" sort="Charalambus, Georgios" uniqKey="Charalambus G" first="Georgios" last="Charalambus">Georgios Charalambus</name><name sortKey="Chrysohoou, Christina" sort="Chrysohoou, Christina" uniqKey="Chrysohoou C" first="Christina" last="Chrysohoou">Christina Chrysohoou</name><name sortKey="Dalakouras, Ioannis" sort="Dalakouras, Ioannis" uniqKey="Dalakouras I" first="Ioannis" last="Dalakouras">Ioannis Dalakouras</name><name sortKey="Kariori, Maria" sort="Kariori, Maria" uniqKey="Kariori M" first="Maria" last="Kariori">Maria Kariori</name><name sortKey="Leontsinis, Ioannis" sort="Leontsinis, Ioannis" uniqKey="Leontsinis I" first="Ioannis" last="Leontsinis">Ioannis Leontsinis</name><name sortKey="Panagiotakos, Demosthenes" sort="Panagiotakos, Demosthenes" uniqKey="Panagiotakos D" first="Demosthenes" last="Panagiotakos">Demosthenes Panagiotakos</name><name sortKey="Papanikolaou, Angelos" sort="Papanikolaou, Angelos" uniqKey="Papanikolaou A" first="Angelos" last="Papanikolaou">Angelos Papanikolaou</name><name sortKey="Sambatakou, Helen" sort="Sambatakou, Helen" uniqKey="Sambatakou H" first="Helen" last="Sambatakou">Helen Sambatakou</name><name sortKey="Siassos, Gerasimos" sort="Siassos, Gerasimos" uniqKey="Siassos G" first="Gerasimos" last="Siassos">Gerasimos Siassos</name><name sortKey="Tousoulis, Dimitrios" sort="Tousoulis, Dimitrios" uniqKey="Tousoulis D" first="Dimitrios" last="Tousoulis">Dimitrios 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