Objective: To describe the evolution of the hospital admissions in the medical and surgical areas and intensive care units and that of the mortality in the hospital of an area affected with average incidence rates of the COVID-19 pandemic. Methods: Observational study of all admissions in the medical services and deaths that were registered between March 1st and April 30th of years 2017, 2018, 2019 and 2020 in a General Hospital. We consider 00.00 on March 14th of 2020 as the beginning of the alarm state and as cut-off point between two periods: before the state of alert (March 1-13) and the state of alert (March 14-April 30) Results: Comparing the months of March-April of years 2017, 2018, 2019 to 2020 a decrease in the number of admissions can be observed : 23,33% (Medical area), 33,46% (Surgical area) and 38,37% (Intensive Care Units), (p<0,0001 in every case). In the medical and surgical areas decreased with the beginning of state of alert's official statement and in Intensive Care Units two weeks after. During peak times patients with COVID-19 took up 9,8% of total beds of the Center. At the same dates fatalities decreased in the medical and surgical areas 3,98% and 13,13% respectively (p=NS) and increased slightly (17,59%; p<0,001) in Intensive Care Units. Conclusions: After the state of alert's official statement in an healthcare area with average impact of COVID19 pandemic, hospital admissions dropped significantly without showing an excess in mortality.
Describir las repercusiones sobre la hospitalización y las características de los pacientes atendidos en las primeras semanas tras la declaración del estado de alarma durante la pandemia por COVID-19 en un hospital general. Métodos: Estudio observacional de todos los ingresos, en todos servicios hospitalarios, entre los días 1 de marzo y 30 de abril de los años 2017, 2018, 2019 y 2020 en un hospital general. La fuente de información fue el conjunto mínimo básico de datos del centro. Consideramos las 00.00 horas del día 14 de marzo como el inicio del estado de alarma y punto de corte entre dos periodos: previo al estado de alarma (días 1 a 13 de marzo) y estado de alarma (días 14 a 30 de abril). Resultados: Tras la declaración del estado de alarma disminuyó el número de hospitalizaciones (p<0.0001), en un rango entre el 3,5% y el 55,9% con respecto al promedio de los 3 años previos en los diez principales servicios médicos y quirúrgicos de adultos y por todas las modalidades de ingreso (p<0.001). En paralelo se redujo la estancia media ( p<0.001) y se incrementó el porcentaje de ingresados de procedencia urbana (p< 0.01). Si bien la mortalidad global no mostró cambios, si aumentaron los fallecidos en las primeras 24 horas de ingreso hospitalario ( p<0.008). Conclusiones: Este estudio describe los mecanismos de reacción y adaptación de un hospital durante el estado de alarma por la pandemia por COVID-19. Nuestros resultados podrían ayudar a otros centros a diseñar y dimensionar sus preparativos.
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