Influence of the Covid-19 pandemic on out-of-hospital cardiac arrest. A Spanish nationwide prospective cohort study
Por:
Rosell Ortiz F, Fernández Del Valle P, Knox EC, Jiménez Fábrega X, Navalpotro Pascual JM, Mateo Rodríguez I, Ruiz Azpiazu JI, Iglesias Vázquez JA, Echarri Sucunza A, Alonso Moreno DF, Forner Canos AB, García-Ochoa Blanco MJ, López Cabeza N, Mainar Gómez B, Batres Gómez S, Cortés Ramas JA, Ceniceros Rozalén MI, Guirao Salas FA, Fernández Martínez B, Daponte Codina A and OHSCAR investigators
Publicada:
1 dic 2020
Ahead of Print:
10 oct 2020
Resumen:
Aims: The influence of the COVID-19 pandemic on attendance to out-of-hospital cardiac arrest (OHCA) has only been described in city or regional settings. The impact of COVID-19 across an entire country with a high infection rate is yet to be explored. Methods: The study uses data from 8629 cases recorded in two time-series (2017/2018 and 2020) of the Spanish national registry. Data from a nonCOVID-19 period and the COVID-19 period (February 1st-April 30th 2020) were compared. During the COVID-19 period, data a further analysis comparing non-pandemic and pandemic weeks (defined according to the WHO declaration on March 11th, 2020) was conducted. The chi-squared analysis examined differences in OHCA attendance and other patient and resuscitation characteristics. Multivariate logistic regression examined survival likelihood to hospital admission and discharge. The multilevel analysis examined the differential effects of regional COVID-19 incidence on these same outcomes. Results: During the COVID-19 period, the incidence of resuscitation attempts declined and survival to hospital admission (OR = 1.72; 95%CI = 1.46-2.04; p < 0.001) and discharge (OR = 1.38; 95%CI = 1.07-1.78; p = 0.013) fell compared to the non-COVID period. This pattern was also observed when comparing non-pandemic weeks and pandemic weeks. COVID-19 incidence impinged significantly upon outcomes regardless of regional variation, with low, medium, and high incidence regions equally affected. Conclusions: The pandemic, irrespective of its incidence, seems to have particularly impeded the pre-hospital phase of OHCA care. Present findings call for the need to adapt out-of-hospital care for periods of serious infection risk. Study registration number: ISRCTN10437835.
Filiaciones:
Rosell Ortiz F:
Servicio de Urgencias Médicas 061, La Rioja, Spain
Fernández Del Valle P:
Fundación para la Formación e Investigación, Extremadura, Spain
Knox EC:
CIBER Epidemiology and Public Health (CIBERESP), Spain
Jiménez Fábrega X:
Sistema de Emergencies Mediques, Catalunya, Spain
Navalpotro Pascual JM:
SUMMA112, Madrid, Spain
Mateo Rodríguez I:
Andalusian School of Public Health, Complutense University of Madrid, CIBER Epidemiology and Public Health (CIBERESP), Andalusian Observatory on Environment and Health (OSMAN), Spain
Ruiz Azpiazu JI:
Servicio de Urgencias Médicas 061, La Rioja, Spain
Iglesias Vázquez JA:
Fundación Pública Urxencias Sanitarias 061, Galicia, Spain
Echarri Sucunza A:
Servicios de Urgencias Extrahospitalarias de Navarra, Spain
Alonso Moreno DF:
Emergentziak-Emergencias, Osakidetza, Euzkadi, Spain
:
SAMU, Emergencias Sanitarias, Comunidad Valenciana, Spain
García-Ochoa Blanco MJ:
SAMUR Protección Civil, Spain
López Cabeza N:
Emergencias Sanitarias, Castilla y León, Spain
Mainar Gómez B:
061 e Instituto de Ciencias de la Salud, Aragón, Spain
Batres Gómez S:
Emergencias Sanitarias de Extremadura, Spain
Cortés Ramas JA:
Servicio de Bomberos de Zaragoza, Aragón, Spain
Ceniceros Rozalén MI:
SAMU 061 Baleares, Spain
Guirao Salas FA:
Servicio de Emergencias 061, Murcia, Spain
Fernández Martínez B:
Servicio de Emergencia 061, Cantabria, Spain
Daponte Codina A:
Andalusian Observatory on Environment and Health (OSMAN), Andalusian School of Public Health, CIBER Epidemiology and Public Health (CIBERESP), Spain
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