PMID- 32719037
OWN - NLM
STAT- MEDLINE
DCOM- 20201002
LR  - 20240426
IS  - 1473-4893 (Electronic)
IS  - 1470-2118 (Print)
IS  - 1470-2118 (Linking)
VI  - 20
IP  - 5
DP  - 2020 Sep
TI  - Predictive model of increased mortality and bed occupancy if thrombolysis becomes 
      the initial treatment strategy for STEMI during the SARS-CoV-2 pandemic.
PG  - e170-e172
LID - 10.7861/clinmed.2020-0293 [doi]
AB  - During the current SARS-CoV-2 pandemic the restructure of healthcare services to 
      meet the huge increase in demand for hospital resource and capacity has led to 
      the proposal that where necessary ST elevation myocardial infarction (STEMI) 
      could be managed by intravenous thrombolysis in the first instance as a means of 
      reducing the workforce requirements of a primary angioplasty service run at a 
      heart attack centre. Our modelling, based on data from the UK, shows that 
      contrary to reducing demand, the effect on both mortality and bed occupancy would 
      be negative with 158 additional deaths per year for each 10% reduction in primary 
      angioplasty and at a cost of ~8,000 additional bed days per year for the same 
      reduction. Our analysis demonstrates that specialist services such as heart 
      attack pathways should be protected during the COVID crisis to maximise the 
      appropriate use of resource and prevent unnecessary mortality.
CI  - (c) Royal College of Physicians 2020. All rights reserved.
FAU - Dancy, Luke
AU  - Dancy L
AD  - King's College Hospital NHS Foundation Trust, London, UK.
FAU - O'Gallagher, Kevin
AU  - O'Gallagher K
AD  - The King's College London British Heart Foundation Centre of Research Excellence, 
      London, UK kevin.o'gallagher@kcl.ac.uk.
FAU - Ryan, Matthew
AU  - Ryan M
AD  - The King's College London British Heart Foundation Centre of Research Excellence, 
      London, UK.
FAU - MacCarthy, Philip A
AU  - MacCarthy PA
AD  - King's College Hospital NHS Foundation Trust, London, UK.
FAU - Shah, Ajay M
AU  - Shah AM
AD  - The King's College London British Heart Foundation Centre of Research Excellence, 
      London, UK.
LA  - eng
GR  - CH/1999001/11735/BHF_/British Heart Foundation/United Kingdom
PT  - Journal Article
PT  - Review
DEP - 20200727
PL  - England
TA  - Clin Med (Lond)
JT  - Clinical medicine (London, England)
JID - 101092853
SB  - IM
MH  - Aged
MH  - Bed Occupancy/*statistics & numerical data
MH  - COVID-19
MH  - Coronavirus Infections/*epidemiology/prevention & control
MH  - Female
MH  - Hospital Mortality/trends
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care
MH  - Pandemics/prevention & control/*statistics & numerical data
MH  - Percutaneous Coronary Intervention/statistics & numerical data
MH  - Pneumonia, Viral/*epidemiology/prevention & control
MH  - Risk Assessment
MH  - ST Elevation Myocardial Infarction/diagnosis/*mortality/*therapy
MH  - Severe Acute Respiratory Syndrome/epidemiology/prevention & control
MH  - Thrombolytic Therapy/methods/*statistics & numerical data
MH  - United Kingdom
PMC - PMC7539733
OTO - NOTNLM
OT  - COVID-19
OT  - STEMI
OT  - primary PCI
OT  - thrombolysis
EDAT- 2020/07/29 06:00
MHDA- 2020/10/03 06:00
PMCR- 2020/09/01
CRDT- 2020/07/29 06:00
PHST- 2020/07/29 06:00 [pubmed]
PHST- 2020/10/03 06:00 [medline]
PHST- 2020/07/29 06:00 [entrez]
PHST- 2020/09/01 00:00 [pmc-release]
AID - S1470-2118(24)03501-2 [pii]
AID - clinmedicine [pii]
AID - 10.7861/clinmed.2020-0293 [doi]
PST - ppublish
SO  - Clin Med (Lond). 2020 Sep;20(5):e170-e172. doi: 10.7861/clinmed.2020-0293. Epub 
      2020 Jul 27.