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Our new paper is out!
Excess cardiac deaths due to reduced attendance at emergency departments (accepted in Circulation: Cardiovascular Quality and Outcomes)
Video:
Pre-print: https://www.ahajournals.org/doi/pdf/10.1161/CIRCOUTCOMES.120.007085
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Excess cardiac deaths due to reduced attendance at emergency departments (accepted in Circulation: Cardiovascular Quality and Outcomes)
Video:
Pre-print: https://www.ahajournals.org/doi/pdf/10.1161/CIRCOUTCOMES.120.007085
(1/12)
In this study, we focused on the relationship of the reduced attendances at emergency departments for suspected cardiac conditions with increased cardiac mortality in the initial phase of the pandemic
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(2/12)
We used data from the Public Health England EDSSS weekly bulletins and from cardiac deaths from the Office of National Statistics for England from this year (12/18/2019-4/15/2020) as well as the average counts of the previous years
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(3/12)
We utilised an instrumented difference-in-differences design, using the COVID-19 pandemic as an instrument
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(4/12)
To define the level of the instrumental variable, we selected March 12, the date when the UK Chief Medical Officers raised the UK risk from COVID-19 to high, following the WHO declaration of a global pandemic (March 11)
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(5/12)
We estimated the relationship between ED visits and cardiac deaths by using the two-stage least squares method
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(6/12)
During the initial phase of the pandemic (3/12/20-4/15/20), we estimated a decline of 2750 (2504, 2996) ED visits per week for cardiac disease (~35% decrease compared to the average weekly admission before the pandemic this year)
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(7/12)
Every 100 non-visits to EDs for cardiac disease were associated with between 3.1 (1.5-4.6) and 8.4 (7.0-9.8) excess cardiac deaths, corresponding to lag times of 0 and 18 days respectively between non-visits to EDs and cardiac deaths
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(8/12)
The weekly excess cardiac deaths due to non-attendance at EDs, was estimated to be between 84 (95%CI: 42, 127) and 232 (95%CI, 193, 270) deaths
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(9/12)
The validity of our estimates rests upon the assumption that the COVID-19 pandemic only affects excess cardiac deaths from cardiac disease only through the reduction in ED admissions (exclusion restriction assumption)
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(10/12)
These findings should alert policymakers to the importance of ensuring that any measures introduced to control and manage SARS-CoV-2 infection do not adversely impact the management of acute cardiovascular disease
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(11/12)
I would like to thank @ManuellGomes @alvinaglai @AH_AlbertHenry @SpirosDenaxas
Pagona Lagiou @Vnafilyan @ben_humberstone @amibanerjee1 @profhhemingway @tomlumbers
for their contribution!
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Pagona Lagiou @Vnafilyan @ben_humberstone @amibanerjee1 @profhhemingway @tomlumbers
for their contribution!
(12/12)
