New data from NHS Digital has been used by the University of Oxford for a study looking at the weekly cardiac-related hospital admissions during the COVID-19 pandemic.
The study, published today in The Lancet, used management information from NHS Digital1 that underpins official statistics. This is regularly collected from NHS Hospital Trusts in England to get up-to-date information about admissions to hospital.
Researchers documented a reduction in admissions of patients with heart attacks in England during the COVID-19 pandemic by comparing weekly rates in 2020 with those observed in 20192. They will now monitor progress with reversing this trend and post updated results every month3.
NHS Digital is the national safe haven for health and care data and provided its deep expertise of health data structures to curate information, perform quality assurance and to assist the academic team with their understanding of the data, ensuring that it was used appropriately and to its maximum potential.
Researchers at the University of Oxford, working with NHS Digital, in collaboration with experts from the University of Keele, the University of Leeds, University College London, Imperial College London, Barts Health NHS Trust and the Royal Brompton & Harefield NHS Foundation Trust, have published new research that shows that:
- Hospital admissions with a diagnosis of heart attack in England fell between mid-February and the end of March 2020 as the COVID-19 pandemic developed, with 35% fewer admissions than expected in the last week of March.
- Admissions with the most serious type of heart attack, caused by a complete blockage of an artery supplying part of the heart, fell by about a quarter while rates of admission for heart attacks caused by a partial blockage of blood supply to the heart fell by 42%.
- Admission rates partially recovered in April and May but remain lower than expected.
This research highlights the value to the NHS of researchers being able to gain rapid access to routine healthcare data to address important clinical questions.
Tom Denwood, Executive Director Data, Insights and Statistics, at NHS Digital said: “It was a privilege to make this research possible, in partnership with our academic colleagues, through the provision of our platforms and data, our engineering and analytical expertise, and through our collaborative approach.
“By making the data submitted by NHS providers more rapidly available for secure analysis, we were able both to deliver together at pace and to inform ongoing policy-making in response to COVID-19.
“This research has formed part of a larger, ongoing partnership with many academic institutions and National Institute for Cardiovascular Outcomes Research (NICOR) to provide swift and secure access to essential data that will help unlock some of the critical clinical questions raised by the pandemic.”
Dr Marion Mafham, Clinical Research Fellow at the Nuffield Department of Population Health, University of Oxford, and lead author of the study said: “Our study suggests that many fewer people with heart attacks have attended hospital during this pandemic. It is important that anyone with chest pain calls an ambulance immediately, because every minute of delay increases the risk of dying or experiencing serious complications from a heart attack.”
There was a similar pattern of reduced admissions in different demographic groups. The study found that there was an increase in the proportion of patients receiving procedures to open blocked arteries on the day of admission, and a reduction in the length of stay.
Senior author Professor Colin Baigent, Director of the Medical Research Council Population Health Research Unit at the University of Oxford, said: “Some people may be worried about going to hospital because they fear encountering the coronavirus. But the truth is that, by delaying or not going to hospital, people with heart attacks are at much greater risk of dying from their heart attack than catching the virus, and the NHS is ready and able to provide excellent cardiological care.”
See the updates
COVID-19 Acute Coronary Syndromes
Notes to editors
- The Secondary Uses Service Admitted Patient Care (SUSAPC) dataset is a repository of data hosted by NHS Digital that relates to in-patient care provided in England, which aims to enable reporting and analyses to support the NHS in the delivery of healthcare services. These data are submitted on a regular basis by healthcare providers and at pre-arranged dates during the year, submissions are consolidated, validated and cleaned whilst being processed to be incorporated into the Hospital Episode Statistics (HES) dataset. Analyses from SUSAPC are labelled as ‘management information’, a term used to describe aggregate information collated and used in the normal course of business to inform operational delivery, policy development or the management of organisational performance. This recognises that data may be incomplete in places and is not quality assured to the same extent as HES. Further information reviewing the reporting frequency and diagnosis completeness of the SUSAPC data can be found here.
- A similar pattern of reduction in the numbers of patients attending hospital with heart attacks, and in the numbers receiving PCI, has been observed in several other European countries, as well as in the United States, during the COVID-19 pandemic.
- This data can be found here: https://www.ctsu.ox.ac.uk/research/covid-19-acute-coronary-syndromes
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