RT Journal Article
SR Electronic
T1 Higher clinical acuity and 7-day hospital mortality in non-COVID-19 acute medical admissions: prospective observational study
JF Emergency Medicine Journal
JO Emerg Med J
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 366
OP 370
DO 10.1136/emermed-2020-210030
VO 38
IS 5
A1 Marcus J Lyall
A1 Nazir I Lone
YR 2021
UL http://emj.bmj.com/content/38/5/366.abstract
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.