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. 2020 Dec 11;20(1):97.
doi: 10.1186/s12873-020-00392-1.

NYU-EDA in modelling the effect of COVID-19 on patient volumes in a Finnish emergency department

Jalmari Tuominen  1 , Ville Hällberg  2 , Niku Oksala  3   4 , Ari Palomäki  3   2 , Timo Lukkarinen  5 , Antti Roine  3
Affiliations

NYU-EDA in modelling the effect of COVID-19 on patient volumes in a Finnish emergency department

Jalmari Tuominen et al. BMC Emerg Med. .

Abstract

Background: Emergency departments (EDs) worldwide have been in the epicentre of the novel coronavirus disease (COVID-19). However, the impact of the pandemic and national emergency measures on the number of non-COVID-19 presentations and the assessed acuity of those presentations remain uncertain.

Methods: We acquired a retrospective cohort containing all ED visits in a Finnish secondary care hospital during years 2018, 2019 and 2020. We compared the number of presentations in 2020 during the national state of emergency, i.e. from March 16 to June 11, with numbers from 2018 and 2019. Presentations were stratified using localized New York University Emergency Department Algorithm (NYU-EDA) to evaluate changes in presentations with different acuity levels.

Results: A total of 27,526 presentations were observed. Compared to previous two years, total daily presentations were reduced by 23% (from 113 to 87, p < .001). In NYU-EDA classes, Non-Emergent visits were reduced the most by 42% (from 18 to 10, p < .001). Emergent presentations were reduced by 19 to 28% depending on the subgroup (p < .001). Number of injuries were reduced by 25% (from 27 to 20, p < .001). The NYU-EDA distribution changed statistically significantly with 4% point reduction in Non-Emergent visits (from 16 to 12%, p < .001) and 0.9% point increase in Alcohol-related visits (from 1.6 to 2.5%, p < .001).

Conclusions: We observed a significant reduction in total ED visits in the course of national state of emergency. Presentations were reduced in most of the NYU-EDA groups irrespective of the assessed acuity. A compensatory increase in presentations was not observed in the course of the 3 month lockdown. This implies either reduction in overall morbidity caused by decreased societal activity or widespread unwillingness to seek required medical advice.

Keywords: COVID-19; Emergency department; NYU-EDA; SARS-COV-19.

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Conflict of interest statement

We declare no competing interests.

Figures

Fig. 1
Fig. 1
Impact of COVID-19 on daily arrivals. Please note that since 2020 was a leap year, 29th of February was removed from 2020 vector to align the indices. Black solid line = 2020, dark grey area = range in 2018 and 2019, grey dotted line = mean of 2018 and 2019. The light grey box marks the period from March 16 to June 11. Variance is reduced by using a rolling mean with a centered window of 20 days
Fig. 2
Fig. 2
Impact of COVID-19 on daily arrivals as stratified by NYU-EDA groups. Black solid line = 2020, dark grey area = range in 2018 and 2019, grey dotted line = mean of 2018 and 2019. The light grey box marks the period from March 16 to June 11. Variance is reduced by using a rolling mean with a centered window of 20 days
See this image and copyright information in PMC

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