Key result
The COVID-19 outbreak and postoutbreak periods were associated with a 53% and 38% fall in daily STEMI admissions compared to 2019, and a decline in PCI therapy from 71.3% to 60.1% (p=0.002).
Why the study?
The study evaluated changes in admission rates and healthcare quality for STEMI during the COVID-19 outbreak and postoutbreak periods.
Does the COVID-19 pandemic reduce admission rates and quality of healthcare for STEMI patients?
Cohort (n=1,965)
Yes
Does the COVID-19 pandemic reduce admission rates and quality of healthcare for STEMI patients?
The COVID-19 pandemic led to a significant reduction in STEMI admissions and worsened quality of care metrics, including prolonged door-to-balloon times and lower PCI rates.
STEMI admissions and PCI rates stayed lower post-outbreak with longer door-to-balloon times; leaves open whether targeted recovery strategies can restore pre-pandemic care quality.
OBJECTIVE: To evaluate changes in admission rates for and quality of healthcare of ST-segment-elevation myocardial infarction (STEMI) during the period of the COVID-19 outbreak and postoutbreak. METHODS: We conducted a retrospective study among patients with STEMI in the outbreak time and the postoutbreak time. DESIGN: To examine the changes in the admission rates and in quality of healthcare, by comparison between periods of the postoutbreak and the outbreak, and between the postoutbreak and the corresponding periods. SETTING: Data for this analysis were included from patients discharge diagnosed with STEMI from all the hospitals of Suzhou in each month of the year until the end of July 2020. PARTICIPANTS: 1965 STEMI admissions. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the number of moecondary outcomnthly STEMI admissions, and the secondary outcomes were the quality metrics of STEMI healthcare. RESULTS: There were a 53% and 38% fall in daily admissions at the phase of outbreak and postoutbreak, compared with the 2019 corresponding. There remained a gap in actual number of postoutbreak admissions at 306 and the predicted number at 497, an estimated 26 deaths due to STEMI would have been caused by not seeking healthcare. Postoutbreak period of 2020 compared with corresponding period of 2019, the percentage of cases transferred by ambulance decreased from 9.3% to 4.2% (p=0.013), the door-to-balloon median time increased from 17.5 to 34.0 min (p=0.001) and the rate of percutaneous coronary intervention (PCI) therapy declined from 71.3% to 60.1% (p=0.002). CONCLUSIONS: The impact of public health restrictions may lead to unexpected out-of-hospital deaths and compromised quality of healthcare for acute cardiac events. Delay or absence in patients should be continuously considered avoiding the secondary disaster of the pandemic. System delay should be modifiable for reversing the worst clinical outcomes from the COVID-19 outbreak, by coordination measures with focus on the balance between timely PCI procedure and minimising contamination of cardiac catheterisation rooms.
No takes yet. Share an insight, caveat, or question.
Ma et al. (2022) conducted a cohort in ST-segment-elevation myocardial infarction (STEMI) (n=1,965). COVID-19 pandemic periods (outbreak and postoutbreak) vs. Corresponding periods in 2019 was evaluated on Number of monthly STEMI admissions. The COVID-19 outbreak and postoutbreak periods were associated with a 53% and 38% fall in daily STEMI admissions compared to 2019, and a decline in PCI therapy from 71.3% to 60.1% (p=0.002).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: