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Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries

F L Wright, Kate Cheema, Raph Goldacre, Nick Hall, Naomi Herz, Nazrul Islam, Zainab Karim, David Moreno-Martos, Daniel R Morales, Daniel O'Connell, Enti Spata, Ashley Akbari Orcid Logo, Mark Ashworth, Mark Barber, Norman Briffa, Dexter Canoy, Spiros Denaxas Orcid Logo, Kamlesh Khunti, Amanj Kurdi Orcid Logo, Mamas Mamas Orcid Logo, Rouven Priedon, Cathie Sudlow, Eva J A Morris, Ben Lacey, Amitava Banerjee Orcid Logo

European Heart Journal - Quality of Care and Clinical Outcomes, Volume: 9, Issue: 4

Swansea University Author: Ashley Akbari Orcid Logo

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DOI (Published version): 10.1093/ehjqcco/qcac077

Abstract

BackgroundAlthough morbidity and mortality from COVID-19 have been widely reported, the indirect effects of the pandemic beyond 2020 on other major diseases and health service activity have not been well described.Methods and resultsAnalyses used national administrative electronic hospital records i...

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Published in: European Heart Journal - Quality of Care and Clinical Outcomes
ISSN: 2058-5225 2058-1742
Published: Oxford University Press (OUP) 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa62054
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Admissions and procedures during the pandemic (2020–21) related to six major cardiovascular conditions [acute coronary syndrome (ACS), heart failure (HF), stroke/transient ischaemic attack (TIA), peripheral arterial disease (PAD), aortic aneurysm (AA), and venous thromboembolism(VTE)] were compared with the annual average in the pre-pandemic period (2016–19). Differences were assessed by time period and urgency of care.In 2020, there were 31 064 (−6%) fewer hospital admissions [14 506 (−4%) fewer emergencies, 16 560 (−23%) fewer elective admissions] compared with 2016–19 for the six major cardiovascular diseases (CVDs) combined. The proportional reduction in admissions was similar in all three countries. Overall, hospital admissions returned to pre-pandemic levels in 2021. Elective admissions remained substantially below expected levels for almost all conditions in all three countries [−10 996 (−15%) fewer admissions]. However, these reductions were offset by higher than expected total emergency admissions [+25 878 (+6%) higher admissions], notably for HF and stroke in England, and for VTE in all three countries. Analyses for procedures showed similar temporal variations to admissions.ConclusionThe present study highlights increasing emergency cardiovascular admissions during the pandemic, in the context of a substantial and sustained reduction in elective admissions and procedures. This is likely to increase further the demands on cardiovascular services over the coming years.</abstract><type>Journal Article</type><journal>European Heart Journal - Quality of Care and Clinical Outcomes</journal><volume>9</volume><journalNumber>4</journalNumber><paginationStart/><paginationEnd/><publisher>Oxford University Press (OUP)</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2058-5225</issnPrint><issnElectronic>2058-1742</issnElectronic><keywords/><publishedDay>16</publishedDay><publishedMonth>11</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-11-16</publishedDate><doi>10.1093/ehjqcco/qcac077</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm>SU Library paid the OA fee (TA Institutional Deal)</apcterm><funders>The British Heart Foundation Data Science Centre (grant No SP/19/3/34 678, awarded to Health Data Research (HDR) UK) funded co-development (with NHS Digital) of the TRE, provision of linked datasets, data access, user software licences, computational usage, and data management and wrangling support with additional contributions from the HDR UK Data and Connectivity component of the UK Government Chief Scientific Adviser’s National Core Studies programme to coordinate national covid-19 priority research. Consortium partner organisations funded the time of contributing data analysts, biostatisticians, epidemiologists, and clinicians. This work was supported by the Con-COV team funded by the Medical Research Council (grant number: MR/V028367/1). This work was supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust. This work was supported by the ADR Wales programme of work, aligned to the priority themes 410 as identified in the Welsh Government’s national strategy: Prosperity for All. ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data and Methods (WISERD) at Cardiff University and specialist teams within the Welsh Government to develop new evidence which supports Prosperity for All by using the SAIL Databank at Swansea University, to link and analyse anonymised data. ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant ES/S007393/1). 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spelling v2 62054 2022-11-26 Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 2022-11-26 HDAT BackgroundAlthough morbidity and mortality from COVID-19 have been widely reported, the indirect effects of the pandemic beyond 2020 on other major diseases and health service activity have not been well described.Methods and resultsAnalyses used national administrative electronic hospital records in England, Scotland, and Wales for 2016–21. Admissions and procedures during the pandemic (2020–21) related to six major cardiovascular conditions [acute coronary syndrome (ACS), heart failure (HF), stroke/transient ischaemic attack (TIA), peripheral arterial disease (PAD), aortic aneurysm (AA), and venous thromboembolism(VTE)] were compared with the annual average in the pre-pandemic period (2016–19). Differences were assessed by time period and urgency of care.In 2020, there were 31 064 (−6%) fewer hospital admissions [14 506 (−4%) fewer emergencies, 16 560 (−23%) fewer elective admissions] compared with 2016–19 for the six major cardiovascular diseases (CVDs) combined. The proportional reduction in admissions was similar in all three countries. Overall, hospital admissions returned to pre-pandemic levels in 2021. Elective admissions remained substantially below expected levels for almost all conditions in all three countries [−10 996 (−15%) fewer admissions]. However, these reductions were offset by higher than expected total emergency admissions [+25 878 (+6%) higher admissions], notably for HF and stroke in England, and for VTE in all three countries. Analyses for procedures showed similar temporal variations to admissions.ConclusionThe present study highlights increasing emergency cardiovascular admissions during the pandemic, in the context of a substantial and sustained reduction in elective admissions and procedures. This is likely to increase further the demands on cardiovascular services over the coming years. Journal Article European Heart Journal - Quality of Care and Clinical Outcomes 9 4 Oxford University Press (OUP) 2058-5225 2058-1742 16 11 2022 2022-11-16 10.1093/ehjqcco/qcac077 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University SU Library paid the OA fee (TA Institutional Deal) The British Heart Foundation Data Science Centre (grant No SP/19/3/34 678, awarded to Health Data Research (HDR) UK) funded co-development (with NHS Digital) of the TRE, provision of linked datasets, data access, user software licences, computational usage, and data management and wrangling support with additional contributions from the HDR UK Data and Connectivity component of the UK Government Chief Scientific Adviser’s National Core Studies programme to coordinate national covid-19 priority research. Consortium partner organisations funded the time of contributing data analysts, biostatisticians, epidemiologists, and clinicians. This work was supported by the Con-COV team funded by the Medical Research Council (grant number: MR/V028367/1). This work was supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust. This work was supported by the ADR Wales programme of work, aligned to the priority themes 410 as identified in the Welsh Government’s national strategy: Prosperity for All. ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data and Methods (WISERD) at Cardiff University and specialist teams within the Welsh Government to develop new evidence which supports Prosperity for All by using the SAIL Databank at Swansea University, to link and analyse anonymised data. ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant ES/S007393/1). This work was supported by the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales. 2023-07-12T10:29:03.8409342 2022-11-26T17:46:37.7986726 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine F L Wright 1 Kate Cheema 2 Raph Goldacre 3 Nick Hall 4 Naomi Herz 5 Nazrul Islam 6 Zainab Karim 7 David Moreno-Martos 8 Daniel R Morales 9 Daniel O'Connell 10 Enti Spata 11 Ashley Akbari 0000-0003-0814-0801 12 Mark Ashworth 13 Mark Barber 14 Norman Briffa 15 Dexter Canoy 16 Spiros Denaxas 0000-0001-9612-7791 17 Kamlesh Khunti 18 Amanj Kurdi 0000-0001-5036-1988 19 Mamas Mamas 0000-0001-9241-8890 20 Rouven Priedon 21 Cathie Sudlow 22 Eva J A Morris 23 Ben Lacey 24 Amitava Banerjee 0000-0001-8741-3411 25 62054__28087__568351db167540378964fe9b738bcc89.pdf 62054.VOR.pdf 2023-07-12T10:17:50.4519953 Output 1352741 application/pdf Version of Record true © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. true eng https://creativecommons.org/licenses/by-nc/4.0/
title Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries
spellingShingle Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries
Ashley Akbari
title_short Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries
title_full Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries
title_fullStr Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries
title_full_unstemmed Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries
title_sort Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries
author_id_str_mv aa1b025ec0243f708bb5eb0a93d6fb52
author_id_fullname_str_mv aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
author Ashley Akbari
author2 F L Wright
Kate Cheema
Raph Goldacre
Nick Hall
Naomi Herz
Nazrul Islam
Zainab Karim
David Moreno-Martos
Daniel R Morales
Daniel O'Connell
Enti Spata
Ashley Akbari
Mark Ashworth
Mark Barber
Norman Briffa
Dexter Canoy
Spiros Denaxas
Kamlesh Khunti
Amanj Kurdi
Mamas Mamas
Rouven Priedon
Cathie Sudlow
Eva J A Morris
Ben Lacey
Amitava Banerjee
format Journal article
container_title European Heart Journal - Quality of Care and Clinical Outcomes
container_volume 9
container_issue 4
publishDate 2022
institution Swansea University
issn 2058-5225
2058-1742
doi_str_mv 10.1093/ehjqcco/qcac077
publisher Oxford University Press (OUP)
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description BackgroundAlthough morbidity and mortality from COVID-19 have been widely reported, the indirect effects of the pandemic beyond 2020 on other major diseases and health service activity have not been well described.Methods and resultsAnalyses used national administrative electronic hospital records in England, Scotland, and Wales for 2016–21. Admissions and procedures during the pandemic (2020–21) related to six major cardiovascular conditions [acute coronary syndrome (ACS), heart failure (HF), stroke/transient ischaemic attack (TIA), peripheral arterial disease (PAD), aortic aneurysm (AA), and venous thromboembolism(VTE)] were compared with the annual average in the pre-pandemic period (2016–19). Differences were assessed by time period and urgency of care.In 2020, there were 31 064 (−6%) fewer hospital admissions [14 506 (−4%) fewer emergencies, 16 560 (−23%) fewer elective admissions] compared with 2016–19 for the six major cardiovascular diseases (CVDs) combined. The proportional reduction in admissions was similar in all three countries. Overall, hospital admissions returned to pre-pandemic levels in 2021. Elective admissions remained substantially below expected levels for almost all conditions in all three countries [−10 996 (−15%) fewer admissions]. However, these reductions were offset by higher than expected total emergency admissions [+25 878 (+6%) higher admissions], notably for HF and stroke in England, and for VTE in all three countries. Analyses for procedures showed similar temporal variations to admissions.ConclusionThe present study highlights increasing emergency cardiovascular admissions during the pandemic, in the context of a substantial and sustained reduction in elective admissions and procedures. This is likely to increase further the demands on cardiovascular services over the coming years.
published_date 2022-11-16T10:29:01Z
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score 11.016235

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