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Exploration of Cardiology Patient Hospital Presentations, Health Care Utilisation and Cardiovascular Risk Factors During the COVID-19 Pandemic - 22/03/23

Doi : 10.1016/j.hlc.2022.11.013 
Kenneth Cho, MBBS, MPhil a, b, , Giuseppe Femia, MBBS, PhD a, b, e, Rosa Lee, MN c, Denusha Nageswararajah, MBBS d, Haresh Doulatram, MBBS c, Kishor Kadappu, MBBS, PhD a, b, c, Craig Juergens, MBBS, DMedSc c, e
a Cardiology Department, Campbelltown Hospital, Sydney, NSW Australia 
b Western Sydney University, Sydney, NSW, Australia 
c Cardiology Department, Liverpool Hospital, Sydney, NSW, Australia 
d Hunter New England Local Health District (LHD), Newcastle, NSW, Australia 
e University of New South Wales, Sydney, NSW, Australia 

Corresponding author at: Department of Cardiology, Liverpool Hospital, Burnside Dr, Liverpool, NSW 2170, AustraliaLiverpool HospitalBurnside DrLiverpoolNSW2170Australia

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Abstract

Objectives

COVID-19 and the lockdowns have affected health care provision internationally, including medical procedures and methods of consultation. We aimed to assess the impact of COVID-19 at two Australian hospitals, focussing on cardiovascular hospital admissions, the use of community resources and cardiovascular risk factor control through a mixed methods approach.

Methods

Admissions data from the quaternary referral hospital were analysed, and 299 patients were interviewed from July 2020 to December 2021. With the admissions data, the number, complexity and mortality of cardiology hospital admissions, prior to the first COVID-19 lockdown (T0=February 2018–July 2019) were compared to after the introduction of COVID-19 lockdowns (T1=February 2020–July 2021). During interviews, we asked patients about hospital and community health resource use, and their control of cardiovascular risk factors from the first lockdown.

Results

Admission data showed a reduction in hospital presentations (T0=138,099 vs T1=128,030) and cardiology admissions after the lockdown period began (T0=4,951 vs T1=4,390). After the COVID-19-related lockdowns began, there was an increased complexity of cardiology admissions (T0=18.7%, 95% CI 17.7%–19.9% vs T1=20.3%, 95% CI 19.1%–21.5%, chi-square test: 4,158.658, p<0.001) and in-hospital mortality (T0=2.3% of total cardiology admissions 95% CI 1.9%–2.8% vs T1=2.8%, 95% CI 2.3%–3.3%, chi-square test: 4,060.217, p<0.001). In addition, 27% of patients delayed presentation due to fears of COVID-19 while several patients reported reducing their general practitioner or pathology/imaging appointments (27% and 11% respectively). Overall, 19% reported more difficulty accessing medical care during the lockdown periods. Patients described changes in their cardiovascular risk factors, including 25% reporting reductions in physical activity.

Conclusion

We found a decrease in hospital presentations but with increased complexity after the introduction of COVID-19 lockdowns. Patients reported being fearful about presenting to hospital and experiencing difficulty in accessing community health services.

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Keywords : Coronavirus, COVID-19, Cardiovascular risk factors, Cardiometabolic risk factors, Secondary prevention


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© 2022  Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 32 - N° 3

P. 348-352 - mars 2023 Retour au numéro
Article précédent Article précédent
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