A population-based analysis of the impact of the COVID-19 pandemic on common abdominal and gynecological emergency department visits
| Autor: | Charles de Mestral, Andrew Wilton, Fahima Dossa, Peter C Austin, Jordan Nantais, Colin Sue-Chue-Lam, David Gomez, Nancy N. Baxter, Andrea Simpson, David Urbach |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Cross-sectional study Population 030230 surgery Abortion Severity of Illness Index Miscarriage 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Cholecystitis Humans 030212 general & internal medicine education Pandemics Aged Ontario education.field_of_study Ectopic pregnancy business.industry Mortality rate Research COVID-19 General Medicine Emergency department Health Services Middle Aged Patient Acceptance of Health Care medicine.disease Appendicitis humanities Pregnancy Ectopic Abortion Spontaneous Cross-Sectional Studies Emergency medicine Female business Emergency Service Hospital Genital Diseases Female Facilities and Services Utilization |
| Zdroj: | CMAJ : Canadian Medical Association Journal |
| ISSN: | 1488-2329 0820-3946 |
| Popis: | BACKGROUND: Reduced use of the emergency department during the COVID-19 pandemic may result in increased disease acuity when patients do seek health care services. We sought to evaluate emergency department visits for common abdominal and gynecologic conditions before and at the beginning of the pandemic to determine whether changes in emergency department attendance had serious consequences for patients. METHODS: We conducted a population-based analysis using administrative data to evaluate the weekly rate of emergency department visits pre-COVID-19 (Jan. 1-Mar. 10, 2020) and during the beginning of the COVID-19 pandemic (Mar. 11-June 30, 2020), compared with a historical control period (Jan. 1-July 1, 2019). All residents of Ontario, Canada, presenting to the emergency department with appendicitis, cholecystitis, ectopic pregnancy or miscarriage were included. We evaluated weekly incidence rate ratios (IRRs) of emergency department visits, management strategies and clinical outcomes. RESULTS: Across all study periods, 39 691 emergency department visits met inclusion criteria (40.2 % appendicitis, 32.1% miscarriage, 21.3% cholecystitis, 6.4% ectopic pregnancy). Baseline characteristics of patients presenting to the emergency department did not vary across study periods. After an initial reduction in emergency department visits, presentations for cholecystitis and ectopic pregnancy quickly returned to expected levels. However, presentations for appendicitis and miscarriage showed sustained reductions (IRR 0.61-0.80), with 1087 and 984 fewer visits, respectively, after the start of the pandemic, relative to 2019. Management strategies, complications and mortality rates were similar across study periods for all conditions. INTERPRETATION: Although our study showed evidence of emergency department avoidance in Ontario during the first wave of the COVID-19 pandemic, no adverse consequences were evident. Emergency care and outcomes for patients were similar before and during the pandemic. |
| Databáze: | OpenAIRE |
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