Summary

Older adults and major cardiovascular events requiring emergency department consultation during the 1st wave of the COVID-19 pandemic: results from the EDEN-4 Study

Pascual Piñera Salmerón1, Javier Jacob2, Òscar Miró3, Guillermo Burillo-Putze4, Eric Jorge García-Lamberechts5, Francisco Javier Montero Pérez6, Sira Aguiló3, Cesáreo Fernández5, Aitor Alquézar-Arbé7, Ana Murcia Olagüenaga8, Francisco Javier Díaz Miguez9, Mar Sousa10, Pedro Ruiz Asensio11, Beatriz Paderne Díaz12, Teresa Pablos Pizarro13, María Ángeles de Juan Gómez14, Núria Perelló Viola15, Lourdes Hernández-Castells16, Alejandro Cortés Soler17, Violeta Delgado Sardina18, Jesús Ángel Sánchez Serrano19, Patxi Ezponda20, Andrea Martínez Lorenzo21, Juan Vicente Ortega Liarte22, Raquel Hernando Fernández23, Asumpta Ruiz Aranda24, Juan González del Castillo4, en representación de la red SIESTA.

Affiliation of the authors

1Servicio de Urgencias, Hospital General Universitario Reina Sofía, Murcia, Spain. 2Servicio de Urgencias, Hospital Universitari de Bellvitge, l’Hospitalet de Llobregat, Barcelona, Spain. 3Servicio de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain. 4Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain. 5Servicio de Urgencias, Hospital Universitario de Canarias, Tenerife, Spain. 6Servicio de Urgencias, Hospital Reina Sofía, Córdoba, Spain. 7Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 8Servicio de Urgencias, Hospital del Nalón, Langreo, Asturias, Spain. 9Servicio de Urgencias, Hospital Altagracia, Manzanares, Ciudad Real, Spain. 10Servicio de Urgencias, Hospital Nuestra Señora del Prado de Talavera de la Reina, Toledo, Spain. 11Servicio de Urgencias, Hospital Universitario Vinalopó, Elche, Alicante, Spain. 12Servicio de Urgencias, Hospital de Móstoles, Madrid, Spain. 13Servicio de Urgencias, Hospital Virgen del Rocío, Sevilla, Spain. 14Servicio de Urgencias, Hospital General Universitario Dr. Peset, Valencia, Spain. 15Servicio de Urgencias, Hospital Universitario Son Espases, Palma de Mallorca, Spain. 16Servicio de Urgencias, Clínica Universitaria Navarra, Madrid, Spain. 17Servicio de Urgencias, Clínico Universitario, Valencia, Spain. 18Servicio de Urgencias, Hospital Álvaro Cunqueiro, Vigo, Spain. 19Servicio de Urgencias, Hospital Universitario, Salamanca, Spain. 20Servicio de Urgencias, Hospital De Zumárraga, Guipúzcoa, Spain. 21Servicio de Urgencias, Hospital Virxe da Xunqueira, A Coruña, Spain. 22Servicio de Urgencias, Hospital Universitario Los Arcos del Mar Menor, San Javier, Murcia, Spain. 23Servicio de Urgencias, Hospital Universitario Río Ortega, Valladolid, Spain. 24Servicio de Urgencias, Hospital Juan Ramón Jiménez, Huelva, Spain.

DOI

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Quote

Piñera Salmerón P, Jacob J, Miró O, Burillo-Putze G, García-Lamberechts EJ, Montero Pérez FJ, et al. Older adults and major cardiovascular events requiring emergency department consultation during the 1st wave of the COVID-19 pandemic: results from the EDEN-4 Study. Emergencias. 2026;38:114-22

Summary

Objective.

To determine the rate, patient profile, and outcomes of emergency department (ED) visits by older adults for major acute cardiovascular events (MACE) during the 1st wave of the COVID-19 pandemic in Spain vs the prepandemic period.

Methods.

We analyzed all patients aged $ 65 years who attended 52 Spanish EDs within 1 week of the 1st COVID-19 wave (April 1–7, 2020; COVID period) and within the same week of the previous year (March 30–April 5, 2019; pre-COVID period). Cardiac events (angina pectoris and myocardial infarction with and without ST-segment elevation) and cerebrovascular events (stroke) were recorded for each period, jointly and individually. We estimated changes in MACE incidence rate per 100,000 persons per year and compared patient characteristics and outcomes (30-day allcause mortality rate, intensive care unit [ICU] admission, and ED revisits, adjusted for patient characteristics) across periods.

Results.

ED visits dropped by 61.8% during the COVID period (from 25,557 to 9,770). During this period, 297 patients attended the ED for MACE (incidence rate, 131.2), vs 488 during the pre-COVID period (incidence rate, 215.6; incidence reduction, 39.1%, 95% CI, 29.7–47.3). The reduction in ED visits was significantly greater (P < .001) for cardiac events (43.3 vs 99.9; reduction 56.6%, 95% CI, 45.0–65.8) than for cerebrovascular events (88.8 vs 116.7; reduction 23.9%, 95% CI, 8.5–36.6). Patients with MACE presenting during the COVID period had lower comorbidity. These patients had fewer ICU admissions (OR, 0.338; 95% CI, 0.149–0.764) and more ED revisits (OR, 1.764; 95% CI, 1.116–2.790), with no differences in 30-day mortality (HR, 1.474; 95% CI, 0.971–2.239).

Conclusions.

During the 1st wave of the COVID-19 pandemic, the rate of ED visits for MACE decreased among older adults. Patients who presented had fewer comorbidities, fewer ICU admissions, and more ED revisits, with no significant changes in mortality.

 

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