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The COVID-19 impact on STEMI disparities
Jessica Folk1,2, Kevin McGurk3, Loretta Au4
1Division of Emergency Medicine, NorthShore University HealthSystem, USA.
Insights
The coronavirus disease 2019 (COVID-19) pandemic did not significantly alter treatment times for ST-segment elevation myocardial infarction (STEMI) patients across different demographics. This study establishes a baseline for monitoring STEMI care equity.
Area of Science:
- Cardiology
- Public Health
- Health Equity
Background:
- ST-segment elevation myocardial infarction (STEMI) remains a leading cause of death and disability.
- Existing health disparities in STEMI care persist despite awareness of social determinants.
- The COVID-19 pandemic impacted emergency healthcare services, necessitating an evaluation of its effect on STEMI care.
Purpose of the Study:
- To investigate potential health disparities in STEMI patient care during the COVID-19 pandemic.
- To compare STEMI intervention turnaround times pre-pandemic (2019) versus during the pandemic (2020).
- To establish a baseline for assessing equitable STEMI care within a hospital system.
Main Methods:
- Retrospective review of STEMI patient data from April to September 2019 and April to September 2020.
- Inclusion criteria: STEMI patients presenting within 12 hours of symptom onset.
- Analysis of turnaround times (emergency department arrival to intervention) stratified by age, gender, and race/ethnicity.
Main Results:
- No statistically significant differences in STEMI intervention turnaround times were observed between the pre-pandemic and pandemic periods.
- Turnaround times remained consistent across various patient subgroups (age, gender, race/ethnicity) during both study periods.
- Despite pandemic-related shifts in emergency department resources, STEMI care timeliness was maintained.
Conclusions:
- The COVID-19 pandemic did not introduce statistically significant disparities in STEMI intervention times based on demographic factors within this health system.
- This study provides a crucial baseline for future assessments of STEMI care equity and the impact of interventions aimed at reducing disparities.
- Continuous monitoring is essential for identifying and addressing any emerging gaps in STEMI care.
Abstract:
ST-segment elevation myocardial infarction (STEMI) is a significant source of morbidity and mortality. Despite guideline-driven management and increased awareness of social determinants of health, there are persistent disparities in diagnosis, management, and outcomes. The coronavirus disease 2019 (COVID-19) pandemic has greatly affected emergency department visitation, conditions and throughput. The aim of this study was to find any potential health disparities in patients who presented with STEMI during the COVID-19 pandemic by reviewing STEMI care data from April to September 2019 (pre-pandemic) and April to September 2020 (during the pandemic) for our hospital system. Patients with STEMI within 12 h of presentation were included in this study, and subdivided by age, gender, and race/ethnicity. We compared the turnaround times between emergency department arrival to intervention (electrocardiogram or catheterization) within the patient subgroups to find any notable differences. No statistically significant changes in turnaround times during either study period were found based on age, gender, or race/ethnicity for the STEMI interventions despite shifts in emergency department resources during the pandemic. This study helped assess the status quo in STEMI intervention for our health system and serves as a baseline for us to monitor gaps in care or areas of improvement. As healthcare systems institute new measures to promote equitable care, such as improving the accuracy of demographic data capture, establishing a baseline is an essential first step in evaluating the impact of these measures.
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