1
|
Fridman SE, Di Giampietro P, Sensoli A, Beleffi M, Bucce C, Salvatore V, Giostra F, Gianstefani A. Prediction of Conventional Oxygen Therapy Failure in COVID-19 Patients With Acute Respiratory Failure by Assessing Serum Lactate Concentration, PaO2/FiO2 Ratio, and Body Temperature. Cureus 2022; 14:e21987. [PMID: 35155050 PMCID: PMC8820760 DOI: 10.7759/cureus.21987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2022] [Indexed: 12/13/2022] Open
|
2
|
Golinelli D, Campinoti F, Sanmarchi F, Rosa S, Beleffi M, Farina G, Tampieri A, Fantini MP, Giostra F, Santi L. Patterns of Emergency Department visits for acute and chronic diseases during the two pandemic waves in Italy. Am J Emerg Med 2021; 50:22-26. [PMID: 34271231 DOI: 10.1016/j.ajem.2021.07.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/28/2021] [Accepted: 07/01/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Evidence is lacking about the impact of subsequent COVID-19 pandemic waves on Emergency Departments (ED). We analyzed the differences in patterns of ED visits in Italy during the two pandemic waves, focusing on changes in accesses for acute and chronic diseases. METHODS We conducted a retrospective study using data from a metropolitan area in northern Italy that includes twelve ED. We analyzed weekly trends in non-COVID-19 ED visits during the first (FW) and second wave (SW) of the pandemic. Incidence rate ratios (IRRs) of triage codes, patient destination, and cause-specific ED visits in the FW and SW of the year 2020 vs. 2019 were estimated using Poisson regression models. MAIN FINDINGS We found a significant decrease of ED visits by triage code, which was more marked for low priority codes and during the FW. We found an increased share of hospitalizations compared to home discharges both in the FW and in the SW. ED visits for acute and chronic conditions decreased during the FW, ranging, from -70% for injuries (IRR = 0.2862, p < 0.001) to -50% and - 60% for ischemic heart disease and heart failure. CONCLUSIONS The two pandemic waves led to a selection of patients with higher and more urgent needs of acute hospital care. These findings should lead to investigate how to improve systems' capacity to manage changes in population needs.
Collapse
Affiliation(s)
- Davide Golinelli
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum - University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy.
| | - Francesca Campinoti
- Department of Emergency, Unità operativa di Medicina d'urgenza e Pronto Soccorso, Policlinico S. Orsola-Malpighi. Via Giuseppe Massarenti, 9, 40138 Bologna, Italy.
| | - Francesco Sanmarchi
- Ospedale S. Maria della Scaletta, Dipartimento di Emergenza-urgenza e Accettazione, Unità Operativa di Pronto Soccorso e Medicina d'Urgenza, Viale Amendola, 2, 40026 Imola, Italy.
| | - Simona Rosa
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum - University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy.
| | - Michelle Beleffi
- Department of Emergency, Unità operativa di Medicina d'urgenza e Pronto Soccorso, Policlinico S. Orsola-Malpighi. Via Giuseppe Massarenti, 9, 40138 Bologna, Italy
| | - Gabriele Farina
- Department of Emergency, Unità operativa di Medicina d'urgenza e Pronto Soccorso, Policlinico S. Orsola-Malpighi. Via Giuseppe Massarenti, 9, 40138 Bologna, Italy.
| | - Andrea Tampieri
- Ospedale S. Maria della Scaletta, Dipartimento di Emergenza-urgenza e Accettazione, Unità Operativa di Pronto Soccorso e Medicina d'Urgenza, Viale Amendola, 2, 40026 Imola, Italy.
| | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum - University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy.
| | - Fabrizio Giostra
- Department of Emergency, Unità operativa di Medicina d'urgenza e Pronto Soccorso, Policlinico S. Orsola-Malpighi. Via Giuseppe Massarenti, 9, 40138 Bologna, Italy.
| | - Luca Santi
- Department of Emergency, Unità operativa di Medicina d'urgenza e Pronto Soccorso, Policlinico S. Orsola-Malpighi. Via Giuseppe Massarenti, 9, 40138 Bologna, Italy.
| |
Collapse
|
3
|
Santi L, Golinelli D, Tampieri A, Farina G, Greco M, Rosa S, Beleffi M, Biavati B, Campinoti F, Guerrini S, Ferrari R, Rucci P, Fantini MP, Giostra F. Non-COVID-19 patients in times of pandemic: Emergency department visits, hospitalizations and cause-specific mortality in Northern Italy. PLoS One 2021; 16:e0248995. [PMID: 33750990 PMCID: PMC7984614 DOI: 10.1371/journal.pone.0248995] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/09/2021] [Indexed: 01/14/2023] Open
Abstract
The COVID-19 pandemic forced healthcare services organization to adjust to mutating healthcare needs. Not exhaustive data are available on the consequences of this on non-COVID-19 patients. The aim of this study was to assess the impact of the pandemic on non-COVID-19 patients living in a one-million inhabitants' area in Northern Italy (Bologna Metropolitan Area-BMA), analyzing time trends of Emergency Department (ED) visits, hospitalizations and mortality. We conducted a retrospective observational study using data extracted from BMA healthcare informative systems. Weekly trends of ED visits, hospitalizations, in- and out-of-hospital, all-cause and cause-specific mortality between December 1st, 2019 to May 31st, 2020, were compared with those of the same period of the previous year. Non-COVID-19 ED visits and hospitalizations showed a stable trend until the first Italian case of COVID-19 has been recorded, on February 19th, 2020, when they dropped simultaneously. The reduction of ED visits was observed in all age groups and across all severity and diagnosis groups. In the lockdown period a significant increase was found in overall out-of-hospital mortality (43.2%) and cause-specific out-of-hospital mortality related to neoplasms (76.7%), endocrine, nutritional and metabolic (79.5%) as well as cardiovascular (32.7%) diseases. The pandemic caused a sudden drop of ED visits and hospitalizations of non-COVID-19 patients during the lockdown period, and a concurrent increase in out-of-hospital mortality mainly driven by deaths for neoplasms, cardiovascular and endocrine diseases. As recurrencies of the COVID-19 pandemic are underway, the scenario described in this study might be useful to understand both the population reaction and the healthcare system response at the early phases of the pandemic in terms of reduced demand of care and systems capability in intercepting it.
Collapse
Affiliation(s)
- Luca Santi
- Department of Emergency, Medicina d’Urgenza e Pronto Soccorso, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Davide Golinelli
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Andrea Tampieri
- Department of Emergency, Medicina d’Urgenza e Pronto Soccorso. Ospedale S. Maria della Scaletta, Imola, Italy
| | - Gabriele Farina
- Department of Emergency, Medicina d’Urgenza e Pronto Soccorso, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Manfredi Greco
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Simona Rosa
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Michelle Beleffi
- Emergency Medicine Specialization School, Alma Mater Studiorum - Università di Bologna, Bologna, Italy
| | - Bianca Biavati
- Emergency Medicine Specialization School, Alma Mater Studiorum - Università di Bologna, Bologna, Italy
| | - Francesca Campinoti
- Emergency Medicine Specialization School, Alma Mater Studiorum - Università di Bologna, Bologna, Italy
| | - Stefania Guerrini
- Department of Emergency, Medicina d’Urgenza e Pronto Soccorso, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Rodolfo Ferrari
- Department of Emergency, Medicina d’Urgenza e Pronto Soccorso. Ospedale S. Maria della Scaletta, Imola, Italy
| | - Paola Rucci
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Fabrizio Giostra
- Department of Emergency, Medicina d’Urgenza e Pronto Soccorso, Policlinico S. Orsola-Malpighi, Bologna, Italy
| |
Collapse
|