Deferral of Non-Emergency Cardiovascular Interventions Triggers Increased Cardiac Emergency Admissions—Analysis of the COVID-19 Related Lockdown

Dominik Felbel, Sascha d’Almeida, Manuel Rattka, Stefanie Andreß, Kathrin Reischmann, Benjamin Mayer, Armin Imhof, Dominik Buckert, Wolfgang Rottbauer, Sinisa Markovic and Tilman Stephan ()
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Dominik Felbel: Department of Cardiology, Angiology, Pneumology and Intensive Care Medicine, University of Ulm, 89081 Ulm, Germany
Sascha d’Almeida: Department of Cardiology, Angiology, Pneumology and Intensive Care Medicine, University of Ulm, 89081 Ulm, Germany
Manuel Rattka: Department of Cardiology, Angiology, Pneumology and Intensive Care Medicine, University of Ulm, 89081 Ulm, Germany
Stefanie Andreß: Department of Cardiology, Angiology, Pneumology and Intensive Care Medicine, University of Ulm, 89081 Ulm, Germany
Kathrin Reischmann: Department of Cardiology, Angiology, Pneumology and Intensive Care Medicine, University of Ulm, 89081 Ulm, Germany
Benjamin Mayer: Institute for Epidemiology and Medical Biometry, Ulm University, 89075 Ulm, Germany
Armin Imhof: Department of Cardiology, Angiology, Pneumology and Intensive Care Medicine, University of Ulm, 89081 Ulm, Germany
Dominik Buckert: Department of Cardiology, Angiology, Pneumology and Intensive Care Medicine, University of Ulm, 89081 Ulm, Germany
Wolfgang Rottbauer: Department of Cardiology, Angiology, Pneumology and Intensive Care Medicine, University of Ulm, 89081 Ulm, Germany
Sinisa Markovic: Department of Cardiology, Angiology, Pneumology and Intensive Care Medicine, University of Ulm, 89081 Ulm, Germany
Tilman Stephan: Department of Cardiology, Angiology, Pneumology and Intensive Care Medicine, University of Ulm, 89081 Ulm, Germany

IJERPH, 2022, vol. 19, issue 24, 1-12

Abstract: Background: Data on the relation between non-emergency and emergency cardiac admission rates during the COVID-19 lockdown and post-lockdown period are sparse. Methods: Consecutive cardiac patients admitted to our tertiary heart center between 1 January and 30 June 2020 were included. The observation period of 6 months was analyzed in total and divided into three defined time periods: the pre-lockdown (1 January–19 March), lockdown (20 March–19 April), and post-lockdown (20 April–30 June) period. These were compared to the reference periods 2019 and 2022 using daily admission rates and incidence rate ratios (IRR). Results: Over the observation period from 1 January to 30 June, cardiac admissions (including non-emergency and emergency) were comparable between 2019, 2020, and 2022 (n = 2889, n = 2952, n = 2956; p = 0.845). However, when compared to the reference period 2019, non-emergency admissions decreased in 2020 (1364 vs. 1663; p = 0.02), while emergency admissions significantly increased (1588 vs. 1226; p < 0.001). Further analysis of the lockdown period revealed that non-emergency admissions dropped by 82% (IRR 0.18; 95%-CI 0.14–0.24; p < 0.001) and 42% fewer invasive cardiac interventions were performed ( p < 0.001), whereas the post-lockdown period showed a 52% increase of emergency admissions (IRR 1.47; 95%-CI 1.31–1.65; p < 0.001) compared to 2019. Conclusions: We demonstrate a drastic surge of emergency cardiac admissions post-COVID-19 related lockdown suggesting that patients who did not keep their non-emergency appointment had to be admitted as an emergency later on.

Keywords: COVID-19; lockdown; cardiac event; non-emergency; emergency; admission; lockdown strategies; deferral (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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