Temporal trends in the presentation of cardiovascular and cerebrovascular emergencies during the COVID-19 pandemic in Germany: an analysis of health insurance claims.
Administrative Claims, Healthcare
Aged
COVID-19
/ epidemiology
Cardiology Service, Hospital
/ trends
Cardiovascular Diseases
/ diagnosis
Cerebrovascular Disorders
/ diagnosis
Comorbidity
Databases, Factual
Emergency Service, Hospital
/ trends
Female
Germany
/ epidemiology
Health Services Accessibility
/ trends
Humans
Male
Patient Acceptance of Health Care
Patient Admission
/ trends
Retrospective Studies
Time Factors
COVID-19
Emergencies
Health services research
Myocardial infarction
Pandemic
Stroke
Journal
Clinical research in cardiology : official journal of the German Cardiac Society
ISSN: 1861-0692
Titre abrégé: Clin Res Cardiol
Pays: Germany
ID NLM: 101264123
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
24
06
2020
accepted:
27
07
2020
pubmed:
5
8
2020
medline:
15
12
2020
entrez:
5
8
2020
Statut:
ppublish
Résumé
The first reports of declining hospital admissions for major cardiovascular emergencies during the COVID-19 pandemic attracted public attention. However, systematic evidence on this subject is sparse. We aimed to investigate the rate of emergent hospital admissions, subsequent invasive treatments and comorbidities during the COVID-19 pandemic in Germany. This was a retrospective analysis of health insurance claims data from the second largest insurance fund in Germany, BARMER. Patients hospitalized for acute myocardial infarction, acute limb ischemia, aortic rupture, stroke or transient ischemic attack (TIA) between January 1, 2019, and May 31, 2020, were included. Admission rates per 100,000 insured, invasive treatments and comorbidities were compared from January-May 2019 (pre-COVID) to January-May 2020 (COVID). A total of 115,720 hospitalizations were included in the current analysis (51.3% females, mean age 72.9 years). Monthly admission rates declined from 78.6/100,000 insured (pre-COVID) to 70.6/100,000 (COVID). The lowest admission rate was observed in April 2020 (61.6/100,000). Administration rates for ST-segment elevation myocardial infarction (7.3-6.6), non-ST-segment elevation myocardial infarction (16.8-14.6), acute limb ischemia (5.1-4.6), stroke (35.0-32.5) and TIA (13.7-11.9) decreased from pre-COVID to COVID. Baseline comorbidities and the percentage of these patients treated with interventional or open-surgical procedures remained similar over time across all entities. In-hospital mortality in hospitalizations for stroke increased from pre-COVID to COVID (8.5-9.8%). Admission rates for cardiovascular and cerebrovascular emergencies declined during the pandemic in Germany, while patients' comorbidities and treatment allocations remained unchanged. Further investigation is warranted to identify underlying reasons and potential implications on patients' outcomes.
Identifiants
pubmed: 32749558
doi: 10.1007/s00392-020-01723-9
pii: 10.1007/s00392-020-01723-9
pmc: PMC7402080
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1540-1548Références
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