Predictive model of increased mortality and bed occupancy if thrombolysis becomes the initial treatment strategy for STEMI during the SARS-CoV-2 pandemic.
Identifieur interne : 000978 ( Main/Corpus ); précédent : 000977; suivant : 000979Predictive model of increased mortality and bed occupancy if thrombolysis becomes the initial treatment strategy for STEMI during the SARS-CoV-2 pandemic.
Auteurs : Luke Dancy ; Kevin O'Gallagher ; Matthew Ryan ; Philip A. Maccarthy ; Ajay M. ShahSource :
- Clinical medicine (London, England) [ 1473-4893 ] ; 2020.
English descriptors
- KwdEn :
- Aged (MeSH), Bed Occupancy (statistics & numerical data), Coronavirus Infections (epidemiology), Coronavirus Infections (prevention & control), Female (MeSH), Hospital Mortality (trends), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Outcome Assessment, Health Care (MeSH), Pandemics (prevention & control), Pandemics (statistics & numerical data), Percutaneous Coronary Intervention (statistics & numerical data), Pneumonia, Viral (epidemiology), Pneumonia, Viral (prevention & control), Risk Assessment (MeSH), ST Elevation Myocardial Infarction (diagnosis), ST Elevation Myocardial Infarction (mortality), ST Elevation Myocardial Infarction (therapy), Severe Acute Respiratory Syndrome (epidemiology), Severe Acute Respiratory Syndrome (prevention & control), Thrombolytic Therapy (methods), Thrombolytic Therapy (statistics & numerical data), United Kingdom (MeSH).
- MESH :
- geographic : United Kingdom.
- diagnosis : ST Elevation Myocardial Infarction.
- epidemiology : Coronavirus Infections, Pneumonia, Viral, Severe Acute Respiratory Syndrome.
- methods : Thrombolytic Therapy.
- mortality : ST Elevation Myocardial Infarction.
- prevention & control : Coronavirus Infections, Pandemics, Pneumonia, Viral, Severe Acute Respiratory Syndrome.
- statistics & numerical data : Bed Occupancy, Pandemics, Percutaneous Coronary Intervention, Thrombolytic Therapy.
- therapy : ST Elevation Myocardial Infarction.
- trends : Hospital Mortality.
- Aged, Female, Humans, Male, Middle Aged, Outcome Assessment, Health Care, Risk Assessment.
Abstract
During the current SARS-CoV-2 pandemic the restructure of healthcare services to meet the huge increase in demand for hospital resource and capacity has led to the proposal that where necessary ST elevation myocardial infarction (STEMI) could be managed by intravenous thrombolysis in the first instance as a means of reducing the workforce requirements of a primary angioplasty service run at a heart attack centre. Our modelling, based on data from the UK, shows that contrary to reducing demand, the effect on both mortality and bed occupancy would be negative with 158 additional deaths per year for each 10% reduction in primary angioplasty and at a cost of ~8,000 additional bed days per year for the same reduction. Our analysis demonstrates that specialist services such as heart attack pathways should be protected during the COVID crisis to maximise the appropriate use of resource and prevent unnecessary mortality.
DOI: 10.7861/clinmed.2020-0293
PubMed: 32719037
PubMed Central: PMC7539733
Links to Exploration step
pubmed:32719037Le document en format XML
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Maccarthy</name><affiliation><nlm:affiliation>King's College Hospital NHS Foundation Trust, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Shah, Ajay M" sort="Shah, Ajay M" uniqKey="Shah A" first="Ajay M" last="Shah">Ajay M. 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Maccarthy</name><affiliation><nlm:affiliation>King's College Hospital NHS Foundation Trust, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Shah, Ajay M" sort="Shah, Ajay M" uniqKey="Shah A" first="Ajay M" last="Shah">Ajay M. Shah</name><affiliation><nlm:affiliation>The King's College London British Heart Foundation Centre of Research Excellence, London, UK.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Clinical medicine (London, England)</title><idno type="eISSN">1473-4893</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Bed Occupancy (statistics & numerical data)</term><term>Coronavirus Infections (epidemiology)</term><term>Coronavirus Infections (prevention & control)</term><term>Female (MeSH)</term><term>Hospital Mortality (trends)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Outcome Assessment, Health Care (MeSH)</term><term>Pandemics (prevention & control)</term><term>Pandemics (statistics & numerical data)</term><term>Percutaneous Coronary Intervention (statistics & numerical data)</term><term>Pneumonia, Viral (epidemiology)</term><term>Pneumonia, Viral (prevention & control)</term><term>Risk Assessment (MeSH)</term><term>ST Elevation Myocardial Infarction (diagnosis)</term><term>ST Elevation Myocardial Infarction (mortality)</term><term>ST Elevation Myocardial Infarction (therapy)</term><term>Severe Acute Respiratory Syndrome (epidemiology)</term><term>Severe Acute Respiratory Syndrome (prevention & control)</term><term>Thrombolytic Therapy (methods)</term><term>Thrombolytic Therapy (statistics & numerical data)</term><term>United Kingdom (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>United Kingdom</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>ST Elevation Myocardial Infarction</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term><term>Severe Acute Respiratory Syndrome</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Thrombolytic Therapy</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>ST Elevation Myocardial Infarction</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Coronavirus Infections</term><term>Pandemics</term><term>Pneumonia, Viral</term><term>Severe Acute Respiratory Syndrome</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Bed Occupancy</term><term>Pandemics</term><term>Percutaneous Coronary Intervention</term><term>Thrombolytic Therapy</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>ST Elevation Myocardial Infarction</term></keywords><keywords scheme="MESH" qualifier="trends" xml:lang="en"><term>Hospital Mortality</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Outcome Assessment, Health Care</term><term>Risk Assessment</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">During the current SARS-CoV-2 pandemic the restructure of healthcare services to meet the huge increase in demand for hospital resource and capacity has led to the proposal that where necessary ST elevation myocardial infarction (STEMI) could be managed by intravenous thrombolysis in the first instance as a means of reducing the workforce requirements of a primary angioplasty service run at a heart attack centre. Our modelling, based on data from the UK, shows that contrary to reducing demand, the effect on both mortality and bed occupancy would be negative with 158 additional deaths per year for each 10% reduction in primary angioplasty and at a cost of ~8,000 additional bed days per year for the same reduction. Our analysis demonstrates that specialist services such as heart attack pathways should be protected during the COVID crisis to maximise the appropriate use of resource and prevent unnecessary mortality.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32719037</PMID><DateCompleted><Year>2020</Year><Month>10</Month><Day>02</Day></DateCompleted><DateRevised><Year>2020</Year><Month>10</Month><Day>09</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1473-4893</ISSN><JournalIssue CitedMedium="Internet"><Volume>20</Volume><Issue>5</Issue><PubDate><Year>2020</Year><Month>09</Month></PubDate></JournalIssue><Title>Clinical medicine (London, England)</Title><ISOAbbreviation>Clin Med (Lond)</ISOAbbreviation></Journal><ArticleTitle>Predictive model of increased mortality and bed occupancy if thrombolysis becomes the initial treatment strategy for STEMI during the SARS-CoV-2 pandemic.</ArticleTitle><Pagination><MedlinePgn>e170-e172</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.7861/clinmed.2020-0293</ELocationID><Abstract><AbstractText>During the current SARS-CoV-2 pandemic the restructure of healthcare services to meet the huge increase in demand for hospital resource and capacity has led to the proposal that where necessary ST elevation myocardial infarction (STEMI) could be managed by intravenous thrombolysis in the first instance as a means of reducing the workforce requirements of a primary angioplasty service run at a heart attack centre. Our modelling, based on data from the UK, shows that contrary to reducing demand, the effect on both mortality and bed occupancy would be negative with 158 additional deaths per year for each 10% reduction in primary angioplasty and at a cost of ~8,000 additional bed days per year for the same reduction. Our analysis demonstrates that specialist services such as heart attack pathways should be protected during the COVID crisis to maximise the appropriate use of resource and prevent unnecessary mortality.</AbstractText><CopyrightInformation>© Royal College of Physicians 2020. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Dancy</LastName><ForeName>Luke</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>King's College Hospital NHS Foundation Trust, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>O'Gallagher</LastName><ForeName>Kevin</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>The King's College London British Heart Foundation Centre of Research Excellence, London, UK kevin.o'gallagher@kcl.ac.uk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ryan</LastName><ForeName>Matthew</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>The King's College London British Heart Foundation Centre of Research Excellence, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>MacCarthy</LastName><ForeName>Philip A</ForeName><Initials>PA</Initials><AffiliationInfo><Affiliation>King's College Hospital NHS Foundation Trust, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shah</LastName><ForeName>Ajay M</ForeName><Initials>AM</Initials><AffiliationInfo><Affiliation>The King's College London British Heart Foundation Centre of Research Excellence, London, UK.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>07</Month><Day>27</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Clin Med (Lond)</MedlineTA><NlmUniqueID>101092853</NlmUniqueID><ISSNLinking>1470-2118</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" 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