Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality - a retrospective study from a Swiss university hospital.
Identifieur interne : 000902 ( Main/Exploration ); précédent : 000901; suivant : 000903Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality - a retrospective study from a Swiss university hospital.
Auteurs : Wolf E. Hautz [Suisse] ; Thomas C. Sauter ; Aristomenis K. Exadakytlos [Suisse] ; Gert Krummrey [Suisse] ; Stefan Schauber [Norvège] ; Martin Müller [Suisse]Source :
- Swiss medical weekly [ 1424-3997 ] ; 2020.
Descripteurs français
- KwdFr :
- Acceptation des soins par les patients (statistiques et données numériques), Accessibilité des services de santé (tendances), Adulte (MeSH), Adulte d'âge moyen (MeSH), Analyse de régression (MeSH), Betacoronavirus (MeSH), Femelle (MeSH), Humains (MeSH), Hôpitaux universitaires (statistiques et données numériques), Incidence (MeSH), Infections à coronavirus (épidémiologie), Maladie grave (épidémiologie), Mâle (MeSH), Pandémies (MeSH), Pneumopathie virale (épidémiologie), Service hospitalier d'urgences (statistiques et données numériques), Services des urgences médicales (statistiques et données numériques), Suisse (épidémiologie), Sujet âgé (MeSH), Études rétrospectives (MeSH).
- MESH :
- statistiques et données numériques : Acceptation des soins par les patients, Hôpitaux universitaires, Service hospitalier d'urgences, Services des urgences médicales.
- tendances : Accessibilité des services de santé.
- épidémiologie : Infections à coronavirus, Maladie grave, Pneumopathie virale, Suisse.
- Adulte, Adulte d'âge moyen, Analyse de régression, Betacoronavirus, Femelle, Humains, Incidence, Mâle, Pandémies, Sujet âgé, Études rétrospectives.
- Wicri :
- geographic : Suisse.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Betacoronavirus (MeSH), Coronavirus Infections (epidemiology), Critical Illness (epidemiology), Emergency Medical Services (statistics & numerical data), Emergency Service, Hospital (statistics & numerical data), Female (MeSH), Health Services Accessibility (trends), Hospitals, University (statistics & numerical data), Humans (MeSH), Incidence (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Patient Acceptance of Health Care (statistics & numerical data), Pneumonia, Viral (epidemiology), Regression Analysis (MeSH), Retrospective Studies (MeSH), Switzerland (epidemiology).
- MESH :
- geographic , epidemiology : Switzerland.
- epidemiology : Coronavirus Infections, Critical Illness, Pneumonia, Viral.
- statistics & numerical data : Emergency Medical Services, Emergency Service, Hospital, Hospitals, University, Patient Acceptance of Health Care.
- trends : Health Services Accessibility.
- Adult, Aged, Betacoronavirus, Female, Humans, Incidence, Male, Middle Aged, Pandemics, Regression Analysis, Retrospective Studies.
Abstract
AIMS OF THE STUDY
While COVID-19 significantly overburdens emergency rooms (ERs) and hospitals in affected areas, ERs elsewhere report a marked decrease in patient numbers. This study aimed to investigate the assumption that patients with urgent problems currently avoid the ER.
METHODS
Electronic health records from the ER of a large Swiss university hospital were extracted for three periods: first, the awareness phase (ap) from the publication of the national government’s initiative “How to protect ourselves” on 1 March 2020 to the lockdown of the country on 16 March; second, the mitigation phase (mp) from 16–30 March; finally, patients presenting in March 2019 were used as a control group. We compared parameters including a critical illness as the discharge diagnosis (e.g., myocardial infarction, stroke, sepsis and ER death) using logistic and linear regression, as well as 15-day bootstrapped means and 95% confidence intervals for the control group.
RESULTS
In the three periods, a total of 7143 patients were treated. We found a 24.9% (42.5%) significant decline in the number of patients presenting during the ap (mp). Patients presenting during the mp were more likely to be critically ill. There was an increase of 233% and 367% (ap and mp, respectively) of ER deaths (none related to COVID-19) compared with the control period. Apart from polytrauma (increase of 5% in the mp), all other critical illnesses as discharge diagnosis showed a lower incidence in descriptive analysis. Significantly more patients died in the ER in both the ap and mp.
CONCLUSIONS
Barriers to seeking emergency care during COVID-19 pandemic may lead to higher morbidity and mortality. Healthcare authorities and hospitals must ensure low barriers to treatment and business as usual for all patients.
DOI: 10.4414/smw.2020.20331
PubMed: 32799308
Affiliations:
Links toward previous steps (curation, corpus...)
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Hautz</name><affiliation wicri:level="1"><nlm:affiliation>Department of Emergency Medicine, Inselspital, University Hospital Bern, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Emergency Medicine, Inselspital, University Hospital Bern</wicri:regionArea><wicri:noRegion>University Hospital Bern</wicri:noRegion></affiliation></author><author><name sortKey="Sauter, Thomas C" sort="Sauter, Thomas C" uniqKey="Sauter T" first="Thomas C" last="Sauter">Thomas C. Sauter</name><affiliation><nlm:affiliation>Department of Emergency Medicine, Inselspital, University Hospital Bern, Switzerland | 0041764693998.</nlm:affiliation><wicri:noCountry code="subField">Switzerland | 0041764693998</wicri:noCountry></affiliation></author><author><name sortKey="Exadakytlos, Aristomenis K" sort="Exadakytlos, Aristomenis K" uniqKey="Exadakytlos A" first="Aristomenis K" last="Exadakytlos">Aristomenis K. Exadakytlos</name><affiliation wicri:level="1"><nlm:affiliation>Department of Emergency Medicine, Inselspital, University Hospital Bern, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Emergency Medicine, Inselspital, University Hospital Bern</wicri:regionArea><wicri:noRegion>University Hospital Bern</wicri:noRegion></affiliation></author><author><name sortKey="Krummrey, Gert" sort="Krummrey, Gert" uniqKey="Krummrey G" first="Gert" last="Krummrey">Gert Krummrey</name><affiliation wicri:level="1"><nlm:affiliation>Department of Emergency Medicine, Inselspital, University Hospital Bern, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Emergency Medicine, Inselspital, University Hospital Bern</wicri:regionArea><wicri:noRegion>University Hospital Bern</wicri:noRegion></affiliation></author><author><name sortKey="Schauber, Stefan" sort="Schauber, Stefan" uniqKey="Schauber S" first="Stefan" last="Schauber">Stefan Schauber</name><affiliation wicri:level="1"><nlm:affiliation>Faculty of Medicine, University of Oslo, Norway.</nlm:affiliation><country xml:lang="fr">Norvège</country><wicri:regionArea>Faculty of Medicine, University of Oslo</wicri:regionArea><wicri:noRegion>University of Oslo</wicri:noRegion></affiliation></author><author><name sortKey="Muller, Martin" sort="Muller, Martin" uniqKey="Muller M" first="Martin" last="Müller">Martin Müller</name><affiliation wicri:level="1"><nlm:affiliation>Department of Emergency Medicine, Inselspital, University Hospital Bern, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Emergency Medicine, Inselspital, University Hospital Bern</wicri:regionArea><wicri:noRegion>University Hospital Bern</wicri:noRegion></affiliation></author></analytic><series><title level="j">Swiss medical weekly</title><idno type="eISSN">1424-3997</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Betacoronavirus (MeSH)</term><term>Coronavirus Infections (epidemiology)</term><term>Critical Illness (epidemiology)</term><term>Emergency Medical Services (statistics & numerical data)</term><term>Emergency Service, Hospital (statistics & numerical data)</term><term>Female (MeSH)</term><term>Health Services Accessibility (trends)</term><term>Hospitals, University (statistics & numerical data)</term><term>Humans (MeSH)</term><term>Incidence (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Pandemics (MeSH)</term><term>Patient Acceptance of Health Care (statistics & numerical data)</term><term>Pneumonia, Viral (epidemiology)</term><term>Regression Analysis (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Switzerland (epidemiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Acceptation des soins par les patients (statistiques et données numériques)</term><term>Accessibilité des services de santé (tendances)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Analyse de régression (MeSH)</term><term>Betacoronavirus (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Hôpitaux universitaires (statistiques et données numériques)</term><term>Incidence (MeSH)</term><term>Infections à coronavirus (épidémiologie)</term><term>Maladie grave (épidémiologie)</term><term>Mâle (MeSH)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (épidémiologie)</term><term>Service hospitalier d'urgences (statistiques et données numériques)</term><term>Services des urgences médicales (statistiques et données numériques)</term><term>Suisse (épidémiologie)</term><term>Sujet âgé (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Switzerland</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Critical Illness</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Emergency Medical Services</term><term>Emergency Service, Hospital</term><term>Hospitals, University</term><term>Patient Acceptance of Health Care</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Acceptation des soins par les patients</term><term>Hôpitaux universitaires</term><term>Service hospitalier d'urgences</term><term>Services des urgences médicales</term></keywords><keywords scheme="MESH" qualifier="tendances" xml:lang="fr"><term>Accessibilité des services de santé</term></keywords><keywords scheme="MESH" qualifier="trends" xml:lang="en"><term>Health Services 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xml:lang="en"><p><b>AIMS OF THE STUDY</b></p><p>While COVID-19 significantly overburdens emergency rooms (ERs) and hospitals in affected areas, ERs elsewhere report a marked decrease in patient numbers. This study aimed to investigate the assumption that patients with urgent problems currently avoid the ER.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Electronic health records from the ER of a large Swiss university hospital were extracted for three periods: first, the awareness phase (ap) from the publication of the national government’s initiative “How to protect ourselves” on 1 March 2020 to the lockdown of the country on 16 March; second, the mitigation phase (mp) from 16–30 March; finally, patients presenting in March 2019 were used as a control group. We compared parameters including a critical illness as the discharge diagnosis (e.g., myocardial infarction, stroke, sepsis and ER death) using logistic and linear regression, as well as 15-day bootstrapped means and 95% confidence intervals for the control group.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>In the three periods, a total of 7143 patients were treated. We found a 24.9% (42.5%) significant decline in the number of patients presenting during the ap (mp). Patients presenting during the mp were more likely to be critically ill. There was an increase of 233% and 367% (ap and mp, respectively) of ER deaths (none related to COVID-19) compared with the control period. Apart from polytrauma (increase of 5% in the mp), all other critical illnesses as discharge diagnosis showed a lower incidence in descriptive analysis. Significantly more patients died in the ER in both the ap and mp.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Barriers to seeking emergency care during COVID-19 pandemic may lead to higher morbidity and mortality. Healthcare authorities and hospitals must ensure low barriers to treatment and business as usual for all patients.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32799308</PMID><DateCompleted><Year>2020</Year><Month>08</Month><Day>31</Day></DateCompleted><DateRevised><Year>2020</Year><Month>08</Month><Day>31</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">1424-3997</ISSN><JournalIssue CitedMedium="Internet"><Volume>150</Volume><PubDate><Year>2020</Year><Month>08</Month><Day>10</Day></PubDate></JournalIssue><Title>Swiss medical weekly</Title><ISOAbbreviation>Swiss Med Wkly</ISOAbbreviation></Journal><ArticleTitle>Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality - a retrospective study from a Swiss university hospital.</ArticleTitle><Pagination><MedlinePgn>w20331</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.4414/smw.2020.20331</ELocationID><ELocationID EIdType="pii" ValidYN="Y">Swiss Med Wkly. 2020;150:w20331</ELocationID><Abstract><AbstractText Label="AIMS OF THE STUDY">While COVID-19 significantly overburdens emergency rooms (ERs) and hospitals in affected areas, ERs elsewhere report a marked decrease in patient numbers. This study aimed to investigate the assumption that patients with urgent problems currently avoid the ER.</AbstractText><AbstractText Label="METHODS">Electronic health records from the ER of a large Swiss university hospital were extracted for three periods: first, the awareness phase (ap) from the publication of the national government’s initiative “How to protect ourselves” on 1 March 2020 to the lockdown of the country on 16 March; second, the mitigation phase (mp) from 16–30 March; finally, patients presenting in March 2019 were used as a control group. We compared parameters including a critical illness as the discharge diagnosis (e.g., myocardial infarction, stroke, sepsis and ER death) using logistic and linear regression, as well as 15-day bootstrapped means and 95% confidence intervals for the control group.</AbstractText><AbstractText Label="RESULTS">In the three periods, a total of 7143 patients were treated. We found a 24.9% (42.5%) significant decline in the number of patients presenting during the ap (mp). Patients presenting during the mp were more likely to be critically ill. There was an increase of 233% and 367% (ap and mp, respectively) of ER deaths (none related to COVID-19) compared with the control period. Apart from polytrauma (increase of 5% in the mp), all other critical illnesses as discharge diagnosis showed a lower incidence in descriptive analysis. Significantly more patients died in the ER in both the ap and mp.</AbstractText><AbstractText Label="CONCLUSIONS">Barriers to seeking emergency care during COVID-19 pandemic may lead to higher morbidity and mortality. Healthcare authorities and hospitals must ensure low barriers to treatment and business as usual for all patients.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Hautz</LastName><ForeName>Wolf E</ForeName><Initials>WE</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine, Inselspital, University Hospital Bern, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sauter</LastName><ForeName>Thomas C</ForeName><Initials>TC</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine, Inselspital, University Hospital Bern, Switzerland | 0041764693998.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Exadakytlos</LastName><ForeName>Aristomenis K</ForeName><Initials>AK</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine, Inselspital, University Hospital Bern, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Krummrey</LastName><ForeName>Gert</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine, Inselspital, University Hospital Bern, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schauber</LastName><ForeName>Stefan</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Faculty of Medicine, University of Oslo, Norway.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Müller</LastName><ForeName>Martin</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine, Inselspital, University Hospital Bern, Switzerland.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>11</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Swiss Med Wkly</MedlineTA><NlmUniqueID>100970884</NlmUniqueID><ISSNLinking>0036-7672</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000453" 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University</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010342" MajorTopicYN="N">Patient Acceptance of Health Care</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000453" 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Sauter</name></noCountry><country name="Suisse"><noRegion><name sortKey="Hautz, Wolf E" sort="Hautz, Wolf E" uniqKey="Hautz W" first="Wolf E" last="Hautz">Wolf E. Hautz</name></noRegion><name sortKey="Exadakytlos, Aristomenis K" sort="Exadakytlos, Aristomenis K" uniqKey="Exadakytlos A" first="Aristomenis K" last="Exadakytlos">Aristomenis K. Exadakytlos</name><name sortKey="Krummrey, Gert" sort="Krummrey, Gert" uniqKey="Krummrey G" first="Gert" last="Krummrey">Gert Krummrey</name><name sortKey="Muller, Martin" sort="Muller, Martin" uniqKey="Muller M" first="Martin" last="Müller">Martin Müller</name></country><country name="Norvège"><noRegion><name sortKey="Schauber, Stefan" sort="Schauber, Stefan" uniqKey="Schauber S" first="Stefan" last="Schauber">Stefan Schauber</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:32799308" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a CovidSeniorV1
| This area was generated with Dilib version V0.6.37. |  |