Reshaping Emergency Care: Dynamics of OHCA and STEMI in a Three-Year Analysis

The COVID-19 pandemic drastically reshaped healthcare in Lombardy, Italy, notably impacting EMS and emergency departments and altering the epidemiology of time-dependent pathologies such as STEMI and OHCA. While previous studies focused on modifications during the pandemic peak, with an increase in...

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Main Authors: Francesca Bottega, Erika Kacerik, Gabriele Perotti, Carlo Signorelli, Giuseppe Ristagno
Format: Article
Language:English
Published: MDPI AG 2024-07-01
Series:Epidemiologia
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Online Access:https://www.mdpi.com/2673-3986/5/3/26
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author Francesca Bottega
Erika Kacerik
Gabriele Perotti
Carlo Signorelli
Giuseppe Ristagno
author_facet Francesca Bottega
Erika Kacerik
Gabriele Perotti
Carlo Signorelli
Giuseppe Ristagno
author_sort Francesca Bottega
collection DOAJ
description The COVID-19 pandemic drastically reshaped healthcare in Lombardy, Italy, notably impacting EMS and emergency departments and altering the epidemiology of time-dependent pathologies such as STEMI and OHCA. While previous studies focused on modifications during the pandemic peak, with an increase in the number of OHCA diagnoses and a reduction in the number of STEMI, little evidence exists regarding the inter-pandemic phases. We analyzed OHCA and STEMI accesses to the ED in the regional emergency department access register (EUOL) for 2019–2021. The analysis revealed a significant difference in monthly diagnosis averages. For STEMI, the change was statistically significant (F(2, 33) = 4.45, <i>p</i> = 0.02), while it was not for OHCA (F(2, 33) = 0.18, <i>p</i> = 0.83). Despite the monthly decreases, the likelihood of receiving a STEMI diagnosis increased with total accesses, OR 1.40 [95% CI 1.25–1.58, <i>p</i> < 0.0001]. Additionally, there was a significant increase in March 2020 discharge diagnoses for OHCA compared to March 2019, OR 3.35 [95% CI 2.88–3.90, <i>p</i> < 0.0001], corresponding to the first pandemic wave. Therefore, our analysis indicates that the epidemiology of STEMI and OHCA was altered during the COVID-19 pandemic.
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spelling doaj-art-8311b6c90d054eb28a6eecef96d733772025-08-20T01:55:31ZengMDPI AGEpidemiologia2673-39862024-07-015336237010.3390/epidemiologia5030026Reshaping Emergency Care: Dynamics of OHCA and STEMI in a Three-Year AnalysisFrancesca Bottega0Erika Kacerik1Gabriele Perotti2Carlo Signorelli3Giuseppe Ristagno4Faculty of Medicine, School of Public Health, University of Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milano, ItalyFaculty of Medicine, School of Public Health, University of Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milano, ItalyAgenzia Regionale Emergenza Urgenza Headquarters (AREU HQ), Via Campanini 6, 20124 Milano, ItalyFaculty of Medicine, School of Public Health, University of Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milano, ItalyDipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Via Festa del Perdono 7, 20122 Milano, ItalyThe COVID-19 pandemic drastically reshaped healthcare in Lombardy, Italy, notably impacting EMS and emergency departments and altering the epidemiology of time-dependent pathologies such as STEMI and OHCA. While previous studies focused on modifications during the pandemic peak, with an increase in the number of OHCA diagnoses and a reduction in the number of STEMI, little evidence exists regarding the inter-pandemic phases. We analyzed OHCA and STEMI accesses to the ED in the regional emergency department access register (EUOL) for 2019–2021. The analysis revealed a significant difference in monthly diagnosis averages. For STEMI, the change was statistically significant (F(2, 33) = 4.45, <i>p</i> = 0.02), while it was not for OHCA (F(2, 33) = 0.18, <i>p</i> = 0.83). Despite the monthly decreases, the likelihood of receiving a STEMI diagnosis increased with total accesses, OR 1.40 [95% CI 1.25–1.58, <i>p</i> < 0.0001]. Additionally, there was a significant increase in March 2020 discharge diagnoses for OHCA compared to March 2019, OR 3.35 [95% CI 2.88–3.90, <i>p</i> < 0.0001], corresponding to the first pandemic wave. Therefore, our analysis indicates that the epidemiology of STEMI and OHCA was altered during the COVID-19 pandemic.https://www.mdpi.com/2673-3986/5/3/26emergency departmentCOVID-19OHCASTEMILombardy region
spellingShingle Francesca Bottega
Erika Kacerik
Gabriele Perotti
Carlo Signorelli
Giuseppe Ristagno
Reshaping Emergency Care: Dynamics of OHCA and STEMI in a Three-Year Analysis
Epidemiologia
emergency department
COVID-19
OHCA
STEMI
Lombardy region
title Reshaping Emergency Care: Dynamics of OHCA and STEMI in a Three-Year Analysis
title_full Reshaping Emergency Care: Dynamics of OHCA and STEMI in a Three-Year Analysis
title_fullStr Reshaping Emergency Care: Dynamics of OHCA and STEMI in a Three-Year Analysis
title_full_unstemmed Reshaping Emergency Care: Dynamics of OHCA and STEMI in a Three-Year Analysis
title_short Reshaping Emergency Care: Dynamics of OHCA and STEMI in a Three-Year Analysis
title_sort reshaping emergency care dynamics of ohca and stemi in a three year analysis
topic emergency department
COVID-19
OHCA
STEMI
Lombardy region
url https://www.mdpi.com/2673-3986/5/3/26
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AT erikakacerik reshapingemergencycaredynamicsofohcaandstemiinathreeyearanalysis
AT gabrieleperotti reshapingemergencycaredynamicsofohcaandstemiinathreeyearanalysis
AT carlosignorelli reshapingemergencycaredynamicsofohcaandstemiinathreeyearanalysis
AT giusepperistagno reshapingemergencycaredynamicsofohcaandstemiinathreeyearanalysis