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Observational Study
. 2024:13:8207.
doi: 10.34172/ijhpm.2024.8207. Epub 2024 May 18.

Analysis of the Prognosis Outcomes and Treatment Delay Among ST-Segment Elevation Myocardial Infarction Patients in Emergency Department Based on the Presence of Symptoms Suggestive of COVID-19

David Samuel Kwak  1 , Joonbum Park  2
Affiliations
Observational Study

Analysis of the Prognosis Outcomes and Treatment Delay Among ST-Segment Elevation Myocardial Infarction Patients in Emergency Department Based on the Presence of Symptoms Suggestive of COVID-19

David Samuel Kwak et al. Int J Health Policy Manag. 2024.

Abstract

Background: During COVID-19 pandemic, the emergency department (ED) was challenged to treat patients with COVID-19-related symptom. Therefore, the aim of this study was to investigate treatment delay and prognostic outcomes in ST-segment elevation myocardial infarction (STEMI) patients during COVID-19 pandemic due to isolation or precaution and compare it with pre-COVID-19 period.

Methods: This was a retrospective observation study using multicenter data with different case mix. Anonymized data were collected through each center's electronic medical data of common case report form. Primary outcomes were number and rate of in-hospital mortality within 28 days. Secondary outcomes were door-to-balloon time and length of stay in the ED. Kaplan-Meier estimation and Cox proportional hazard regression analysis were performed to determine impact of predictors on 28-day in-hospital mortality.

Results: Door-to-balloon time was longer in STEMI patients with COVID-19-related symptom(s) than those without symptom during the COVID-19 period (97.0 [74.8, 139.8] vs. 69.0 [55.0, 102.0] minutes, P<.001). However, there was no significant statistical difference in door-to-balloon time between STEMI patients with and without COVID-19-related symptom(s) during the pre-COVID-19 period (73.0 [61.0, 92.0] vs. 67.0 [54.5, 80.0] minutes, P=.2869). The 28-day mortality rate did not show a statistically significant difference depending on symptoms suggestive of COVID-19 during the pre-COVID-19 period (15.4% vs. 6.8%, P=.1257). However, it was significantly higher during the COVID-19 period (21.1% vs. 6.7%, P=.0102) in patients with COVID-19 suggestive symptoms than in patients without the symptoms.

Conclusion: In Korea, symptoms suggestive of COVID-19 during the pandemic had a significant effect on the increase of door-to-balloon time and 28-day mortality in STEMI patients. Thus, health authorities need to make careful decision in designating symptoms indicated for isolation in ED based on opinions of various medical field experts.

Keywords: COVID-19; Emergency Service; Isolation; Korea; Myocardial Infarction; Patient Safety.

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Conflict of interest statement

Authors declare that they have no competing interests.

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References

    1. Weiss EA, Ngo J, Gilbert GH, Quinn JV. Drive-through medicine: a novel proposal for rapid evaluation of patients during an influenza pandemic. Ann Emerg Med. 2010;55(3):268–273. doi: 10.1016/j.annemergmed.2009.11.025. - DOI - PubMed
    1. Lee J. Better understanding on MERS corona virus outbreak in Korea. J Korean Med Sci. 2015;30(7):835–836. doi: 10.3346/jkms.2015.30.7.835. - DOI - PMC - PubMed
    1. Long B, Carius BM, Chavez S, et al. Clinical update on COVID-19 for the emergency clinician: presentation and evaluation. Am J Emerg Med. 2022;54:46–57. doi: 10.1016/j.ajem.2022.01.028. - DOI - PMC - PubMed
    1. Heinert SW, Riggs R, Prendergast H. Emergency department management of hypertension in the context of COVID-19. CurrHypertens Rep. 2022;24(2):37–43. doi: 10.1007/s11906-022-01169-6. - DOI - PMC - PubMed
    1. Frontera WR, Latimer MR, de Jesús K, Pabón A, González J, Conde JG. Effect of the COVID-19 pandemic on musculoskeletal care in the emergency room. Disaster Med Public Health Prep. 2022;17:e310. doi: 10.1017/dmp.2022.276. - DOI - PMC - PubMed

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