PT  - JOURNAL ARTICLE
AU  - Marcus J Lyall
AU  - Nazir I Lone
TI  - Higher clinical acuity and 7-day hospital mortality in non-COVID-19 acute medical admissions: prospective observational study
AID  - 10.1136/emermed-2020-210030
DP  - 2021 May 01
TA  - Emergency Medicine Journal
PG  - 366--370
VI  - 38
IP  - 5
4099  - http://emj.bmj.com/content/38/5/366.short
4100  - http://emj.bmj.com/content/38/5/366.full
SO  - Emerg Med J2021 May 01; 38
AB  - Objectives To understand the effect of COVID-19 lockdown measures on severity of illness and mortality in non-COVID-19 acute medical admissions.Design A prospective observational study.Setting 3 large acute medical receiving units in NHS Lothian, Scotland.Participants Non-COVID-19 acute admissions (n=1682) were examined over the first 31 days after the implementation of the COVID-19 lockdown policy in the UK on 23 March 2019. Patients admitted over a matched interval in the previous 5 years were used as a comparator cohort (n=14 954).Main outcome measures Patient demography, biochemical markers of clinical acuity and 7-day hospital inpatient mortality.Results Non-COVID-19 acute medical admissions reduced by 44.9% across all three sites in comparison with the mean of the preceding 5 years (p<0.001). Patients arriving during this period were more likely to be male, of younger age and to arrive by emergency ambulance transport. Non-COVID-19 admissions during lockdown had a greater incidence of acute kidney injury, lactic acidaemia and an increased risk of hospital death within 7 days (4.2% vs 2.5%), which persisted after adjustment for confounders (OR 1.87, 95% CI 1.43 to 2.41, p<0.001).Conclusions These data demonstrate a significant reduction in non-COVID-19 acute medical admissions during the early weeks of lockdown. Patients admitted during this period were of higher clinical acuity with a higher incidence of early inpatient mortality.Data may be obtained from a third party and are not publicly available. Data are obtained from Lothian Analytics Services at NHS Lothian. Subject to appropriate local governance procedures, requests can be made for access. Please contact corresponding author.