2019年冠状病毒病对急性冠状动脉综合征的影响:流行病浪潮之间的差异
Vincenzo Sucato1, Giusy Sausa1, Grazia Gambino1
1Division of Cardiology, University Hospital Paolo Giaccone, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Italy.
概括
COVID-19大流行严重影响了急性冠状动脉综合征 (ACS) 患者的护理,第一波显示出由于医院的不准备和患者的恐惧造成的最大管理挑战. 随后的浪潮增加了住院病例,治疗时间和结果发生了变化.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- COVID-19大流行对心血管健康系统产生了间接影响,特别是对于急性冠状动脉综合征 (ACS) 患者.
- 在不同流行病浪潮中,人们对大流行对ACS管理的影响给予了有限的关注.
- 了解这些影响对于在健康危机期间优化心血管保健至关重要.
研究的目的:
- 为了比较四个COVID-19流行浪潮中因ACS住院的患者的流行病学,临床和管理差异.
- 强调大流行对急性冠状动脉综合征管理的负担.
- 分析大流行期间ACS患者结果和医疗保健服务的变化.
主要方法:
- 一项追溯观察性研究,对98名2020年3月至2022年3月期间因ACS入院到冠状动脉重症监护室 (CICU) 的患者进行了观察.
- 患者被分为四组,每组代表一个不同的COVID-19流行浪潮.
- 分析了住院率,治疗时间 (门到气球),停留时间和死亡率的数据.
主要成果:
- 由于ACS而住院的病例逐渐增加,第三波与第一波相比增加了178% (p=0.003).
- 在第三波中,非ST升高心肌梗塞 (NSTEMI) 的住院病例增加了900%.
- 在第三波中观察到更长的门到气球时间; 平均住院时间和死亡率在各波中各不相同,第四波死亡率最高 (9.5%).
结论:
- 由于医院的不准备和患者不愿意寻求护理,ACS的管理在最初的流行浪潮中受到最严重的影响.
- 对感染的恐惧和系统的不准备严重阻碍了ACS护理的提供.
- 流行病浪潮影响了ACS住院率,治疗延迟和患者死亡率,需要在心血管保健中采取适应性策略.
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