Changes in the care of acute cerebrovascular and cardiovascular conditions during the first year of the covid-19 pandemic in 746 hospitals in the USA: retrospective analysis
Objective To measure the impact of the covid-19 pandemic on admissions to hospital and interventions for acute ischemic stroke and acute myocardial infarction.Design A retrospective analysis.Setting 746 qualifying hospitals in the USA from the Premier Healthcare Database.Participants Patients aged 1...
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BMJ Publishing Group
2023-10-01
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| Series: | BMJ Medicine |
| Online Access: | https://bmjmedicine.bmj.com/content/2/1/e000207.full |
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| author | Raul G Nogueira Diogo C Haussen Alhamza R Al-Bayati Thanh N Nguyen Charlene Wong Rahul Khanna Rajesh Sachdeva Michael McDaniel Mahmoud H Mohammaden Bernardo Liberato Dinesh V Jillella Michael Frankel Carlos del Rio Shelly Ikeme Katherine Etter Chandan M Devireddy Mohamed F Doheim Agostinho C Pinheiro Nirav R Bhatt |
| author_facet | Raul G Nogueira Diogo C Haussen Alhamza R Al-Bayati Thanh N Nguyen Charlene Wong Rahul Khanna Rajesh Sachdeva Michael McDaniel Mahmoud H Mohammaden Bernardo Liberato Dinesh V Jillella Michael Frankel Carlos del Rio Shelly Ikeme Katherine Etter Chandan M Devireddy Mohamed F Doheim Agostinho C Pinheiro Nirav R Bhatt |
| author_sort | Raul G Nogueira |
| collection | DOAJ |
| description | Objective To measure the impact of the covid-19 pandemic on admissions to hospital and interventions for acute ischemic stroke and acute myocardial infarction.Design A retrospective analysis.Setting 746 qualifying hospitals in the USA from the Premier Healthcare Database.Participants Patients aged 18 years and older who were admitted to hospital with a primary diagnosis of acute ischemic stroke or acute myocardial infarction between 1 March 2019 and 28 February 2021.Main outcome measures Relative changes in volumes were assessed for acute ischemic stroke and acute myocardial infarction hospital admissions as well as intravenous thrombolysis, mechanical thrombectomy, and percutaneous coronary intervention (overall and for acute myocardial infarction only) across the first year of the pandemic versus the prior year. Mortality in hospital and length of stay in hospital were also compared across the first year of the pandemic versus the corresponding period the year prior. These metrics were explored across the different pandemic waves.Results Among 746 qualifying hospitals, admissions to hospital were significantly reduced after the covid-19 pandemic compared with before the pandemic for acute ischemic stroke (−13.59% (95% confidence interval−13.77% to −13.41%) and acute myocardial infarction (−17.20% (−17.39% to −17.01%)), as well as intravenous thrombolysis (−9.47% (−9.99% to −9.02%)), any percutaneous coronary intervention (−17.89% (−18.06% to −17.71%)), and percutaneous coronary intervention for acute myocardial infarction (−14.36% (−14.59% to −14.12%)). During the first year of the pandemic versus the previous year, the odds of mortality in hospital for acute ischemic stroke were 9.00% higher (3.51% v 3.16%; ratio of the means 1.09 (95% confidence interval (1.03 to 1.15); P=0.0013) and for acute myocardial infarction were 18.00% higher (4.81% v 4.29%; ratio of the means 1.18 (1.13 to 1.23); P<0.0001).Conclusions We observed substantial decreases in admissions to hospital with acute ischemic stroke and acute myocardial infarction, but an increase in mortality in hospital throughout the first year of the pandemic. Public health interventions are needed to prevent these reductions in future pandemics. |
| format | Article |
| id | doaj-art-b6a007759afc466eb4cc5b43aca56bf7 |
| institution | OA Journals |
| issn | 2754-0413 |
| language | English |
| publishDate | 2023-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Medicine |
| spelling | doaj-art-b6a007759afc466eb4cc5b43aca56bf72025-08-20T02:30:35ZengBMJ Publishing GroupBMJ Medicine2754-04132023-10-012110.1136/bmjmed-2022-000207Changes in the care of acute cerebrovascular and cardiovascular conditions during the first year of the covid-19 pandemic in 746 hospitals in the USA: retrospective analysisRaul G Nogueira0Diogo C Haussen1Alhamza R Al-Bayati2Thanh N Nguyen3Charlene Wong4Rahul Khanna5Rajesh Sachdeva6Michael McDaniel7Mahmoud H Mohammaden8Bernardo Liberato9Dinesh V Jillella10Michael Frankel11Carlos del Rio12Shelly Ikeme13Katherine Etter14Chandan M Devireddy15Mohamed F Doheim16Agostinho C Pinheiro17Nirav R Bhatt18Neurosurgery, UPMC Stroke Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USANeurology, Emory University School of Medicine, Atlanta, Georgia, USADepartment of Neurology, UPMC Stroke Institute, University of Pittsburgh, Pittsburgh, PA, USA6 Diagnostic and Interventional Neuroradiology, Boston Medical Center, Boston, Massachusetts, USAGlobal Provider and Payer Value Demonstration, Health Economics and Market Access, Johnson & Johnson, Raynham, MA, USAMedical Device Epidemiology, Johnson and Johnson Medical Devices, New Brunswick, NJ, USADepartment of Cardiology, Veterans Affairs Medical Center, Atlanta, GA, USADepartment of Cardiology, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USADepartment of Neurology, Emory University School of Medicine, Atlanta, GA, USADepartment of Neurology, Emory University School of Medicine, Atlanta, Georgia, USADepartment of Neurology, Emory University School of Medicine, Atlanta, GA, USAMarcus Stroke and Neuroscience Center, Grady Memorial Hospital, Atlanta, GA, USADepartment of Medicine, Grady Memorial Hospital, Atlanta, GA, USAFranchise Health Economics and Market Access, Johnson & Johnson, New Brunswick, NJ, USAGlobal Provider and Payer Value Demonstration, Health Economics and Market Access, Johnson & Johnson, Raynham, MA, USADepartment of Cardiology, Emory University Hospital Midtown, Emory University School of Medicine, Atlanta, GA, USANeurology, UPMC Stroke Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USADepartment of Neurology, UPMC Stroke Institute, University of Pittsburgh, Pittsburgh, PA, USADepartment of Neurology, UPMC Stroke Institute, University of Pittsburgh, Pittsburgh, PA, USAObjective To measure the impact of the covid-19 pandemic on admissions to hospital and interventions for acute ischemic stroke and acute myocardial infarction.Design A retrospective analysis.Setting 746 qualifying hospitals in the USA from the Premier Healthcare Database.Participants Patients aged 18 years and older who were admitted to hospital with a primary diagnosis of acute ischemic stroke or acute myocardial infarction between 1 March 2019 and 28 February 2021.Main outcome measures Relative changes in volumes were assessed for acute ischemic stroke and acute myocardial infarction hospital admissions as well as intravenous thrombolysis, mechanical thrombectomy, and percutaneous coronary intervention (overall and for acute myocardial infarction only) across the first year of the pandemic versus the prior year. Mortality in hospital and length of stay in hospital were also compared across the first year of the pandemic versus the corresponding period the year prior. These metrics were explored across the different pandemic waves.Results Among 746 qualifying hospitals, admissions to hospital were significantly reduced after the covid-19 pandemic compared with before the pandemic for acute ischemic stroke (−13.59% (95% confidence interval−13.77% to −13.41%) and acute myocardial infarction (−17.20% (−17.39% to −17.01%)), as well as intravenous thrombolysis (−9.47% (−9.99% to −9.02%)), any percutaneous coronary intervention (−17.89% (−18.06% to −17.71%)), and percutaneous coronary intervention for acute myocardial infarction (−14.36% (−14.59% to −14.12%)). During the first year of the pandemic versus the previous year, the odds of mortality in hospital for acute ischemic stroke were 9.00% higher (3.51% v 3.16%; ratio of the means 1.09 (95% confidence interval (1.03 to 1.15); P=0.0013) and for acute myocardial infarction were 18.00% higher (4.81% v 4.29%; ratio of the means 1.18 (1.13 to 1.23); P<0.0001).Conclusions We observed substantial decreases in admissions to hospital with acute ischemic stroke and acute myocardial infarction, but an increase in mortality in hospital throughout the first year of the pandemic. Public health interventions are needed to prevent these reductions in future pandemics.https://bmjmedicine.bmj.com/content/2/1/e000207.full |
| spellingShingle | Raul G Nogueira Diogo C Haussen Alhamza R Al-Bayati Thanh N Nguyen Charlene Wong Rahul Khanna Rajesh Sachdeva Michael McDaniel Mahmoud H Mohammaden Bernardo Liberato Dinesh V Jillella Michael Frankel Carlos del Rio Shelly Ikeme Katherine Etter Chandan M Devireddy Mohamed F Doheim Agostinho C Pinheiro Nirav R Bhatt Changes in the care of acute cerebrovascular and cardiovascular conditions during the first year of the covid-19 pandemic in 746 hospitals in the USA: retrospective analysis BMJ Medicine |
| title | Changes in the care of acute cerebrovascular and cardiovascular conditions during the first year of the covid-19 pandemic in 746 hospitals in the USA: retrospective analysis |
| title_full | Changes in the care of acute cerebrovascular and cardiovascular conditions during the first year of the covid-19 pandemic in 746 hospitals in the USA: retrospective analysis |
| title_fullStr | Changes in the care of acute cerebrovascular and cardiovascular conditions during the first year of the covid-19 pandemic in 746 hospitals in the USA: retrospective analysis |
| title_full_unstemmed | Changes in the care of acute cerebrovascular and cardiovascular conditions during the first year of the covid-19 pandemic in 746 hospitals in the USA: retrospective analysis |
| title_short | Changes in the care of acute cerebrovascular and cardiovascular conditions during the first year of the covid-19 pandemic in 746 hospitals in the USA: retrospective analysis |
| title_sort | changes in the care of acute cerebrovascular and cardiovascular conditions during the first year of the covid 19 pandemic in 746 hospitals in the usa retrospective analysis |
| url | https://bmjmedicine.bmj.com/content/2/1/e000207.full |
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