tetano
Editor, Senior Moderator
CJC Open
. 2022 Jun 22.
doi: 10.1016/j.cjco.2022.06.006. Online ahead of print.
Increased mortality in patients with acutely decompensated heart failure during the Covid-19 pandemic in Toronto, Canada
Tayler A Buchan[SUP] 1 [/SUP], Lakshmi Kugathasan[SUP] 1 [/SUP], Jeremy Kobulnik[SUP] 1 2 [/SUP], Stephanie Poon[SUP] 3 [/SUP], Kyle Runeckles[SUP] 1 [/SUP], Steve Fan[SUP] 1 [/SUP], Heather J Ross[SUP] 1 [/SUP], Ana C Alba[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease 2019 (Covid-19) has resulted in a reduction in patients seeking timely consultations for non-Covid-19 related illnesses. Previously, we have reported a decline in acute decompensated heart failure (ADHF) related emergency department (ED) visits and hospitalizations during the 2020 Covid-19 pandemic versus 2019. We aimed to determine the consequences of these early trends on ADHF-patient morbidity and mortality.
Methods: We compared consecutive patients presenting with ADHF to 3 academic medical centres in Toronto, Canada from March 1-September 28, 2020, versus the same time period in 2019. We used multivariate logistic regression models to evaluate whether the odds of hospitalization after presenting to the ED, recurrent ED visits or readmission in 30-days, and in-hospital all-cause mortality differed by timeframe.
Results: During the Covid-19 pandemic, we observed a lower total number of patients presenting to hospital with ADHF, as compared to 2019. Despite this, the probability of being admitted to hospital did not differ among patients seen in 2020 versus 2019. Among ADHF patients admitted to hospital, however, we observed a significantly higher proportion of patients being admitted to the ICU and a relative 66% increase in in-hospital mortality during the 2020 Covid-19 era as compared to 2019.
Conclusions: Our findings suggest that improved messaging may be needed for patients living with chronic health conditions, including HF during the pandemic, to educate and encourage patients to present to hospital services when in need.
. 2022 Jun 22.
doi: 10.1016/j.cjco.2022.06.006. Online ahead of print.
Increased mortality in patients with acutely decompensated heart failure during the Covid-19 pandemic in Toronto, Canada
Tayler A Buchan[SUP] 1 [/SUP], Lakshmi Kugathasan[SUP] 1 [/SUP], Jeremy Kobulnik[SUP] 1 2 [/SUP], Stephanie Poon[SUP] 3 [/SUP], Kyle Runeckles[SUP] 1 [/SUP], Steve Fan[SUP] 1 [/SUP], Heather J Ross[SUP] 1 [/SUP], Ana C Alba[SUP] 1 [/SUP]
Affiliations
- PMID: 35765461
- PMCID: PMC9221741
- DOI: 10.1016/j.cjco.2022.06.006
Abstract
Background: Coronavirus disease 2019 (Covid-19) has resulted in a reduction in patients seeking timely consultations for non-Covid-19 related illnesses. Previously, we have reported a decline in acute decompensated heart failure (ADHF) related emergency department (ED) visits and hospitalizations during the 2020 Covid-19 pandemic versus 2019. We aimed to determine the consequences of these early trends on ADHF-patient morbidity and mortality.
Methods: We compared consecutive patients presenting with ADHF to 3 academic medical centres in Toronto, Canada from March 1-September 28, 2020, versus the same time period in 2019. We used multivariate logistic regression models to evaluate whether the odds of hospitalization after presenting to the ED, recurrent ED visits or readmission in 30-days, and in-hospital all-cause mortality differed by timeframe.
Results: During the Covid-19 pandemic, we observed a lower total number of patients presenting to hospital with ADHF, as compared to 2019. Despite this, the probability of being admitted to hospital did not differ among patients seen in 2020 versus 2019. Among ADHF patients admitted to hospital, however, we observed a significantly higher proportion of patients being admitted to the ICU and a relative 66% increase in in-hospital mortality during the 2020 Covid-19 era as compared to 2019.
Conclusions: Our findings suggest that improved messaging may be needed for patients living with chronic health conditions, including HF during the pandemic, to educate and encourage patients to present to hospital services when in need.