J Korean Med Sci.  2023 Jul;38(30):e243. 10.3346/jkms.2023.38.e243.

Impact of the COVID-19 Pandemic on Admission and Mortality Among Patients With Severe Emergency Diseases at Emergency Departments in Korea in 2020: Registry Data From the National Emergency Department Information System

Affiliations
  • 1Department of Healthcare, Graduate School of Nursing & Health Professions, Chung-Ang University, Seoul, Korea
  • 2National Emergency Medical Center of National Medical Center, Seoul, Korea
  • 3Division of Chronic Disease Investigation, Capital Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Seoul, Korea
  • 4Department of Food and Resource Economics, College of Life Science and Biotechnology, Korea University Graduate School, Seoul, Korea
  • 5Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, Korea

Abstract

We aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on admissions of patients with acute myocardial infarction, stroke, and severe trauma, and their excess mortality in emergency departments (EDs) in South Korea using registry data from the National Emergency Department Information System (NEDIS) for patients attending EDs of regional and local emergency medical centers. During the outbreak period of 2020, there were 350,698 ED visits, which was lower than the total in 2019 (392,627 visits). Multiple logistic regression revealed that, compared with 2019, there was significantly higher ED mortality rate during the COVID-19 outbreak in 2020 (adjusted odds ratio, 1.10; 95% confidence interval, 1.07–1.13). This finding implies that during the early outbreak period, people might have avoided seeking medical care even for acute and life-threatening conditions, or transfer times at the scene to the hospital arrival were delayed, or treatment for the patients in EDs were delayed.

Keyword

COVID-19; Emergency Department; Severe Emergency Patients; Mortality; Korea

Reference

1. Korea Disease Control and Prevention Agency. Coronavirus (COVID-19), Republic of Korea occurrence status. Accessed November 13, 2022. https://ncov.mohw.go.kr/en/ .
2. Korea Disease Control and Prevention Agency. Korean government’s COVID-19 response system. Basic Guidelines for Distancing in Daily Life. Updated 2020. Accessed November 13, 2022. https://ncov.kdca.go.kr/en/guidelineView.do?brdId=18&brdGubun=181&dataGubun=&ncvContSeq=2763&contSeq=2763&board_id=&gubun= .
3. Kim SJ, Kim H, Park YH, Kang CY, Ro YS, Kim OH. Analysis of the impact of the coronavirus disease epidemic on the emergency medical system in South Korea using the Korean Triage and Acuity Scale. Yonsei Med J. 2021; 62(7):631–639. PMID: 34164961.
4. Lee DE, Ro YS, Ryoo HW, Moon S. Impact of temporary closures of emergency departments during the COVID-19 outbreak on clinical outcomes for emergency patients in a metropolitan area. Am J Emerg Med. 2021; 47:35–41. PMID: 33756131.
5. Lee SH, Mun YH, Ryoo HW, Jin SC, Kim JH, Ahn JY, et al. Delays in the management of patients with acute ischemic stroke during the COVID-19 outbreak period: a multicenter study in Daegu, Korea. Emerg Med Int. 2021; 2021:6687765. PMID: 33833878.
6. Kim YJ, Choe JY, Kwon KT, Hwang S, Choi GS, Sohn JH, et al. How to keep patients and staff safe from accidental SARS-CoV-2 exposure in the emergency room: lessons from South Korea’s explosive COVID-19 outbreak. Infect Control Hosp Epidemiol. 2021; 42(1):18–24. PMID: 32729441.
7. Jaehn P, Holmberg C, Uhlenbrock G, Pohl A, Finkenzeller T, Pawlik MT, et al. Differential trends of admissions in accident and emergency departments during the COVID-19 pandemic in Germany. BMC Emerg Med. 2021; 21(1):42. PMID: 33823795.
8. Primessnig U, Pieske BM, Sherif M. Increased mortality and worse cardiac outcome of acute myocardial infarction during the early COVID-19 pandemic. ESC Heart Fail. 2021; 8(1):333–343. PMID: 33283476.
9. Wu J, Mamas M, Rashid M, Weston C, Hains J, Luescher T, et al. Patient response, treatments, and mortality for acute myocardial infarction during the COVID-19 pandemic. Eur Heart J Qual Care Clin Outcomes. 2021; 7(3):238–246. PMID: 32730620.
10. Simonsen CZ, Blauenfeldt RA, Hedegaard JN, Kruuse C, Gaist D, Wienecke T, et al. COVID-19 did not result in increased hospitalization for stroke and transient ischemic attack: a nationwide study. Eur J Neurol. 2022; 29(8):2269–2274. PMID: 35397183.
11. Grunau B, Helmer J, Lee S, Acker J, Deakin J, Armour R, et al. Decrease in emergency medical services utilization during early stages of the COVID-19 pandemic in British Columbia. CJEM. 2021; 23(2):237–241. PMID: 33709367.
12. Sharma R, Kuohn LR, Weinberger DM, Warren JL, Sansing LH, Jasne A, et al. Excess cerebrovascular mortality in the United States during the COVID-19 pandemic. Stroke. 2021; 52(2):563–572. PMID: 33430638.
13. National Medical Center. The Factors of ER Overcrowding and Emergency Transfer Rate by the Ratio of Severe Emergency Patients (NMC2015-PR-04). Seoul, Korea: National Medical Center;2016.
14. Korean Ministry of Health and Welfare, Korean National Emergency Center. National Emergency Department Information System (NEDIS). Seoul, Korea: Korean Ministry of Health and Welfare and Korean National Emergency Medical Center;2022.
15. Wu J, Mamas MA, Mohamed MO, Kwok CS, Roebuck C, Humberstone B, et al. Place and causes of acute cardiovascular mortality during the COVID-19 pandemic. Heart. 2021; 107(2):113–119. PMID: 32988988.
16. Yeh CC, Chien CY, Lee TY, Liu CH. Effect of the COVID-19 pandemic on emergency department visits of patients with an emergent or urgent diagnosis. Int J Gen Med. 2022; 15:4657–4664. PMID: 35548587.
Full Text Links
  • JKMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr