PDF(Pubmed)
Abstract：
UNASSIGNED: Chest pain is a common chief complaint in pediatric emergency departments (EDs). Coronavirus disease-2019 (COVID-19) has been shown to increase the risk of cardiac disease. It remains unclear how COVID-19 changed how pediatric emergency clinicians approach patients presenting with chest pain. The goal of this study was to characterize the diagnostic testing for chest pain in a pediatric ED before and during the COVID-19 pandemic.
UNASSIGNED: This was a retrospective study of children between the ages of 2-17 years presenting to a pediatric ED from 1/1/2018-2/29/2020 (Pre-COVID-19) and 3/1/2020-4/30/2022 (COVID-19) with chest pain. We excluded patients with a previous history of cardiac disease.
UNASSIGNED: Of the 10,721 encounters during the study period, 5,692 occurred before and 5,029 during COVID-19. Patient demographics showed minor differences by age, weight, race and ethnicity. ED encounters for chest pain consisted of an average of 18% more imaging studies during COVID-19, including 14% more EKGs and 11% more chest x-rays, with no difference in the number of echocardiograms. Compared to Pre-COVID-19, 100% more diagnostic tests were ordered during COVID-19, including cardiac markers Troponin I (p < 0.001) and BNP (p < 0.001). During COVID-19, 1.1% of patients had a cardiac etiology of chest pain compared with 0.7% before COVID-19 (p = 0.03).
UNASSIGNED: During COVID-19, pediatric patients with chest pain underwent more diagnostic testing compared to Pre-COVID-19. This may be due to higher patient acuity, emergence of multisystem inflammatory syndrome in children (MIS-C) that necessitated more extensive testing and possible changes in ED clinician behavior during COVID-19.
UNASSIGNED: This was a retrospective study of children between the ages of 2-17 years presenting to a pediatric ED from 1/1/2018-2/29/2020 (Pre-COVID-19) and 3/1/2020-4/30/2022 (COVID-19) with chest pain. We excluded patients with a previous history of cardiac disease.
UNASSIGNED: Of the 10,721 encounters during the study period, 5,692 occurred before and 5,029 during COVID-19. Patient demographics showed minor differences by age, weight, race and ethnicity. ED encounters for chest pain consisted of an average of 18% more imaging studies during COVID-19, including 14% more EKGs and 11% more chest x-rays, with no difference in the number of echocardiograms. Compared to Pre-COVID-19, 100% more diagnostic tests were ordered during COVID-19, including cardiac markers Troponin I (p < 0.001) and BNP (p < 0.001). During COVID-19, 1.1% of patients had a cardiac etiology of chest pain compared with 0.7% before COVID-19 (p = 0.03).
UNASSIGNED: During COVID-19, pediatric patients with chest pain underwent more diagnostic testing compared to Pre-COVID-19. This may be due to higher patient acuity, emergence of multisystem inflammatory syndrome in children (MIS-C) that necessitated more extensive testing and possible changes in ED clinician behavior during COVID-19.
摘要：
胸痛是儿科急诊科（ED）常见的主诉。冠状病毒病-2019（COVID-19）已被证明会增加患心脏病的风险。目前尚不清楚COVID-19如何改变儿科急诊临床医生如何对待出现胸痛的患者。这项研究的目的是在COVID-19大流行之前和期间对小儿ED的胸痛进行诊断测试。
■这是一项对2-17岁儿童的回顾性研究，这些儿童在2018年1月1日至2020年2月29日（Pre-COVID-19）和2022年3月1日至4月30日（COVID-19）出现小儿ED并伴有胸痛。我们排除了既往有心脏病史的患者。
■在研究期间的10721次相遇中，在COVID-19之前发生了5,692次，在COVID-19期间发生了5,029次。患者人口统计学显示年龄差异很小，体重,种族和民族。胸痛的ED发作包括COVID-19期间平均增加18%的影像学检查，包括增加14%的心电图和增加11%的胸部X光检查，超声心动图的数量没有差异。与前COVID-19相比，COVID-19期间订购的诊断测试增加了100%，包括心脏标志物肌钙蛋白I(p<0.001)和BNP(p<0.001)。在COVID-19期间，1.1%的患者有胸痛的心脏病因，而COVID-19之前为0.7%(p=0.03)。
在COVID-19期间，与COVID-19之前相比，患有胸痛的儿科患者接受了更多的诊断测试。这可能是由于较高的患者的敏锐度，儿童多系统炎症综合征(MIS-C)的出现需要进行更广泛的检测，并在COVID-19期间可能改变ED临床医生的行为。
■这是一项对2-17岁儿童的回顾性研究，这些儿童在2018年1月1日至2020年2月29日（Pre-COVID-19）和2022年3月1日至4月30日（COVID-19）出现小儿ED并伴有胸痛。我们排除了既往有心脏病史的患者。
■在研究期间的10721次相遇中，在COVID-19之前发生了5,692次，在COVID-19期间发生了5,029次。患者人口统计学显示年龄差异很小，体重,种族和民族。胸痛的ED发作包括COVID-19期间平均增加18%的影像学检查，包括增加14%的心电图和增加11%的胸部X光检查，超声心动图的数量没有差异。与前COVID-19相比，COVID-19期间订购的诊断测试增加了100%，包括心脏标志物肌钙蛋白I(p<0.001)和BNP(p<0.001)。在COVID-19期间，1.1%的患者有胸痛的心脏病因，而COVID-19之前为0.7%(p=0.03)。
在COVID-19期间，与COVID-19之前相比，患有胸痛的儿科患者接受了更多的诊断测试。这可能是由于较高的患者的敏锐度，儿童多系统炎症综合征(MIS-C)的出现需要进行更广泛的检测，并在COVID-19期间可能改变ED临床医生的行为。
