MP03: Clearing the air: A retrospective cohort study of cannabis-related harms in urban Alberta emergency departments following legalization

Introduction: Non-medical cannabis recently became legal on October 18th, 2018 to Canadian adults. The impact of legalization on Emergency Departments (EDs) has been identified as a major concern. The study objective was to identify changes in cannabis-related ED visits and changes in co-existing diagnoses associated with cannabis-related ED visits pre- and post-legalization for the entire urban population of Alberta. Urban Alberta was defined as Calgary and Edmonton, inclusive of Sherwood Park and St. Albert given the proximity of some Edmontonians to their EDs) encompassing 12 adult EDs and 2 pediatric EDs. Methods: Retrospective data was collected from the National Ambulatory Care Reporting System, and from the HealthLink and the Alberta Poison and Drug Information Service (PADIS) public telehealth call databases. An interrupted time-series analysis was completed via segmented regression calculation in addition to incident rate and relative risk ratio calculation for the pre- and post-legalization periods to identify both differences among the entire urban Alberta population and differences among individuals presenting to the ED. Data was collected from October 1st, 2013 up to July 31st, 2019 for ED visits and was adjusted for natural population increase using quarterly reports from the Government of Alberta. Results: The sample included 11 770 pre-legalization cannabis-related visits, and 2962 post-legalization visits. Volumes of ED visits for cannabis-related harms were found to increase post-legalization within urban EDs (IRR 1.45, 95% CI 1.39, 1.51; absolute level change: 43.48 visits per month in urban Alberta, 95% CI 26.52, 60.43), and for PADIS calls (IRR 1.87, 95% CI 1.55, 2.37; absolute level change: 4.02 calls per month in Alberta, 95% CI 0.11, 7.94). The increase in visits to EDs equates to an increase of 2.72 visits per month, per ED. Lastly, increases were observed for cannabinoid hyperemesis (RR 1.23, 95% CI 1.10, 1.36), unintentional ingestion (RR 1.48, 95% CI 1.34, 1.62), and in individuals leaving the ED pre-treatment (RR 1.28, 95% CI 1.08, 1.49). Decreases were observed for coingestant use (RR 0.77, 95% CI 0.73, 0.81) and hospital admissions (RR 0.88, 95% CI 0.80, 0.96). Conclusion: Overall, national legalization of cannabis appears to be correlated with a small increase in cannabis-related ED visits and poison control calls. Post-legalization, fewer patients are being admitted, though cannabinoid hyperemesis appears to be on the rise.

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Clearing the air: A study of cannabis-related presentations to urban Alberta emergency departments following legalization

CJEM ◽

10.1017/cem.2020.384 ◽

2020 ◽

Vol 22 (6) ◽

pp. 776-783

Author(s):

Matthew E. M. Yeung ◽

Colin G. Weaver ◽

Kevin Janz ◽

Rebecca Haines-Saah ◽

Eddy Lang

Keyword(s):

Emergency Departments ◽

Interrupted Time Series ◽

Poison Control ◽

Medical Cannabis ◽

Interrupted Time Series Analysis ◽

Absolute Level ◽

Level Change ◽

Control Centre ◽

Ed Visits ◽

Pre Treatment

ABSTRACTObjectivesNon-medical cannabis recently became legal for adults in Canada. Legalization provides opportunity to investigate the public health effects of national cannabis legalization on presentations to emergency departments (EDs). Our study aimed to explore association between cannabis-related ED presentations, poison control and telemedicine calls, and cannabis legalization.MethodsData were collected from the National Ambulatory Care Reporting System from October 1, 2013, to July 31, 2019, for 14 urban Alberta EDs, from Alberta poison control, and from HealthLink, a public telehealth service covering all of Alberta. Visitation data were obtained to compare pre- and post-legalization periods. An interrupted time-series analysis accounting for existing trends was completed, in addition to the incidence rate ratio (IRR) and relative risk calculation (to evaluate changes in co-diagnoses).ResultsAlthough only 3 of every 1,000 ED visits within the time period were attributed to cannabis, the number of cannabis-related ED presentations increased post-legalization by 3.1 (range -11.5 to 12.6) visits per ED per month (IRR 1.45, 95% confidence interval [CI]; 1.39, 1.51; absolute level change: 43.5 visits per month, 95% CI; 26.5, 60.4). Cannabis-related calls to poison control also increased (IRR 1.87, 95% CI; 1.55, 2.37; absolute level change: 4.0 calls per month, 95% CI; 0.1, 7.9). Lastly, we observed increases in cannabis-related hyperemesis, unintentional ingestion, and individuals leaving the ED pre-treatment. We also observed a decrease in co-ingestant use.ConclusionOverall, Canadian cannabis legalization was associated with small increases in urban Alberta cannabis-related ED visits and calls to a poison control centre.

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Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01779-9 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Antonio Leon-Justel ◽

Jose I. Morgado Garcia-Polavieja ◽

Ana Isabel Alvarez-Rios ◽

Francisco Jose Caro Fernandez ◽

Pedro Agustin Pajaro Merino ◽

...

Keyword(s):

Heart Failure ◽

Hospital Admissions ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Secondary Outcome ◽

Ventricular Ejection Fraction ◽

Number Of Patients ◽

Ed Visits ◽

The Impact

Abstract Background Heart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF with a reduced left ventricular ejection fraction (HFrEF). Methods This is a before and after interventional study, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before the intervention and again after the intervention. The primary objective was the rate of readmissions, due to a HF. Secondary outcome compared the rate of ED visits and quality of life improvement assessed by the number of patients who had reduced NYHA score. A cost-analysis was also performed on these data. Results Admission rates significantly decreased by 19.8% after the intervention (from 30.2 to 10.4), the total hospital admissions were reduced by 32 (from 78 to 46) and the total length of stay was reduced by 7 days (from 15 to 9 days). The rate of ED visits was reduced by 44% (from 64 to 20). Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was € 72,769 per patient (from € 201,189 to € 128,420) and €139,717.65 for the whole group over 1 year. Conclusions A personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care-associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.

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The impact of lockdown on pediatric ED visits and hospital admissions during the COVID19 pandemic: a multicenter analysis and review of the literature

European Journal of Pediatrics ◽

10.1007/s00431-021-04015-0 ◽

2021 ◽

Cited By ~ 1

Author(s):

Matthijs D. Kruizinga ◽

Daphne Peeters ◽

Mirjam van Veen ◽

Marlies van Houten ◽

Jantien Wieringa ◽

...

Keyword(s):

The Netherlands ◽

Hospital Admissions ◽

Clinical Care ◽

Pediatric Emergency ◽

Pediatric Care ◽

Care Utilization ◽

Admission Data ◽

Multicenter Analysis ◽

Ed Visits ◽

The Impact

AbstractThe coronavirus disease 2019 pandemic has enormous impact on society and healthcare. Countries imposed lockdowns, which were followed by a reduction in care utilization. The aims of this study were to quantify the effects of lockdown on pediatric care in the Netherlands, to elucidate the cause of the observed reduction in pediatric emergency department (ED) visits and hospital admissions, and to summarize the literature regarding the effects of lockdown on pediatric care worldwide. ED visits and hospital admission data of 8 general hospitals in the Netherlands between January 2016 and June 2020 were summarized per diagnosis group (communicable infections, noncommunicable infections, (probable) infection-related, and noninfectious). The effects of lockdown were quantified with a linear mixed effects model. A literature review regarding the effect of lockdowns on pediatric clinical care was performed. In total, 126,198 ED visits and 47,648 admissions were registered in the study period. The estimated reduction in general pediatric care was 59% and 56% for ED visits and admissions, respectively. The largest reduction was observed for communicable infections (ED visits: 76%; admissions: 77%), whereas the reduction in noninfectious diagnoses was smaller (ED visits 36%; admissions: 37%). Similar reductions were reported worldwide, with decreases of 30–89% for ED visits and 19–73% for admissions.Conclusion: Pediatric ED utilization and hospitalization during lockdown were decreased in the Netherlands and other countries, which can largely be attributed to a decrease in communicable infectious diseases. Care utilization for other conditions was decreased as well, which may indicate that care avoidance during a pandemic is significant. What is Known:• The COVID-19 pandemic had enormous impact on society.• Countries imposed lockdowns to curb transmission rates, which were followed by a reduction in care utilization worldwide. What is New:• The Dutch lockdown caused a significant decrease in pediatric ED utilization and hospitalization, especially in ED visits and hospital admissions because of infections that were not caused by SARS-CoV-2.• Care utilization for noninfectious diagnoses was decreased as well, which may indicate that pediatric care avoidance during a pandemic is significant.

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Impact of the COVID-19 Outbreak on Emergency Resources – An Observational Multicenter Study Including All Hospitals in a Major Urban Center of the Rhein Ruhr Metropolitan Region

10.21203/rs.3.rs-97392/v1 ◽

2020 ◽

Author(s):

Sebastian Bergrath ◽

Tobias Strapatsas ◽

Michael Tuemen ◽

Thorsten Reith ◽

Marc Deussen ◽

...

Keyword(s):

Data Analysis ◽

Multicenter Study ◽

Social Life ◽

Hospital Admissions ◽

Statistical Significance ◽

Urban Center ◽

Medical Specialties ◽

Work Related ◽

Ed Visits ◽

The Impact

Abstract Background: The outbreak of the coronavirus disease 2019 (COVID-19) caused by the severe respiratory distress syndrome coronavirus 2 (SARS-CoV-2) led to severe disruption in social life and economics. The present study should analyze the impact of the local COVID-19 epidemic on emergency resources for all hospitals in a major urban center (Moenchengladbach, Germany). Methods: An observational multicenter study was performed involving all four acute care hospitals. Systemic parameters department (ED) parameters from week 4 to 24 in 2020 were compared to the corresponding period in 2019 for each hospital and in a summative data analysis using a logistic regression model. Outcomes: ED visits, ED to hospital admission, ED to Intensive Care Unit (ICU) admission, medical specialties of admitted patients, work related accidents. Results: In week 9/2020 the first SARS-CoV-2 positive patients were detected in our region. All hospitals decided to minimize elective admissions to ensure operational capability for COVID-19 patients. The summative number of ED visits dropped from 34,659 to 28,008. Numbers decreased from week 8 on between 38% and 48% per week per hospital at the maximum and began to rise again from week 16 on. The pooled data analysis showed statistically significant decreases in outpatient ED visits (20,152 vs. 16,477, p=<0.001), hospital admissions of ED patients (14,507 vs. 11,531, p=<0.001), and work-related accidents (2,290 vs. 1,468, p=<0.001). The decrease in admissions from ED to ICU did not reach statistical significance (2,093 vs. 1,566, p=0.255). The decline in ED cases was mainly caused by a decrease in non-trauma and non-surgical patients. Conclusion: The regional COVID-19 outbreak led to significantly reduced ED contacts after the first COVID-19 cases appeared. Even the admissions to the hospitals and the number of ED to ICU-admissions decreased, which is potentially dangerous, because the ratio of emergency outpatients vs. inpatients remained stable. Therefore, one can assume that patients with severe medical problems did not seek ED care in many cases. The decline of patients was earlier than in other German hospitals and in contrast to the findings in the U.S. and Italy where ED visits and hospital admissions in medical disciplines increased.

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Can interactive parental education impact health care utilization in pediatric asthma: A study in rural Texas

Journal of International Medical Research ◽

10.1177/0300060518773621 ◽

2018 ◽

Vol 46 (8) ◽

pp. 3172-3182 ◽

Cited By ~ 3

Author(s):

Vijay Agusala ◽

Priyanka Vij ◽

Veena Agusala ◽

Vivekanand Dasari ◽

Bhargavi Kola

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Parental Education ◽

Pediatric Patients ◽

Hospital Admissions ◽

Care Utilization ◽

Asthma Education ◽

Before And After ◽

Ed Visits ◽

The Impact

Objective It is well known that parent/patient education helps to reduce the burden of asthma in urban areas, but data are scarce for rural areas. This study explored the impact of asthma education in Ector County, a rural part of Health Services Region 9 in Texas, which has one of the highest prevalence rates of asthma in the state. Methods This prospective study investigated an interactive asthma education intervention in pediatric patients aged 2–18 years and their caregivers. Change in parental/caregiver knowledge about their child’s asthma along with frequency of missed school days, emergency department (ED) visits and hospital admissions was obtained via telephone surveys before and after the educational intervention was delivered. Results The study enrolled 102 pediatric patients and their parents/caregivers. Asthma education was associated with significantly fewer school absences, ED visits and hospitalizations. Parents/caregivers reported feeling better educated, knowing what triggers an asthma exacerbation, identifying the signs of a severe asthma attack in their child, feeling confident about managing asthma and feeling that the asthma was under control. Conclusion Asthma education of caregivers and children was associated with better symptom management and fewer acute exacerbations, pointing to the relevance and importance of asthma education among pediatric patients in rural areas.

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3247 Implementing an Interdisciplinary, Student-Run Consult Service for Homeless Patients: The Critical Role of Community Partnerships

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.210 ◽

2019 ◽

Vol 3 (s1) ◽

pp. 91-91

Author(s):

Frances Loretta Gill

Keyword(s):

Health Care ◽

Health Care Utilization ◽

Hospital Admissions ◽

Community Partnerships ◽

Care Utilization ◽

Consult Service ◽

Utilization Patterns ◽

Ed Visits ◽

Hospital Days ◽

The Impact

OBJECTIVES/SPECIFIC AIMS: Elucidate the unique challenges associated with hospital discharge planning for patients experiencing homelessness. Assess the impact of robust community partnerships and strong referral pathways on participating patients’ health care utilization patterns in an interdisciplinary, student-run hospital consult service for patients experiencing homelessness. Identify factors (both patient-level and intervention-level) that are associated with successful warm hand-offs to outside social agencies at discharge. METHODS/STUDY POPULATION: To assess the impact of participation in HHL on patients’ health care utilization, we conducted a medical records review using the hospital’s electronic medical record system comparing patients’ health care utilization patterns during the nine months pre- and post- HHL intervention. Utilization metrics included number of ED visits and hospital admissions, number of hospital days, 30-day hospital readmissions, total hospital costs, and follow-up appointment attendance rates, as well as percentage of warm hand-offs to community-based organizations upon discharge. Additionally, we collected data regarding patient demographics, duration of homelessness, and characteristics of homelessness (primarily sheltered versus primarily unsheltered, street homeless versus couch surfing, etc) and intervention outcome data (i.e. percentage of warm hand-offs). This study was reviewed and approved by the Tulane University Institutional Review Board and the University Medical Center Research Review Committee. RESULTS/ANTICIPATED RESULTS: For the first 41 patients who have been enrolled in HHL, participation in HHL is associated with a statistically significant decrease in hospital admissions by 49.4% (p < 0.01) and hospital days by 47.7% (p < 0.01). However, the intervention is associated with a slight, although not statistically significant, increase in emergency department visits. Additionally, we have successfully accomplished warm hand-offs at discharge for 71% percent of these patients. Over the next year, many more patients will be enrolled in HHL, which will permit a more finely grained assessment to determine which aspects of the HHL intervention are most successful in facilitating warm hand-offs and decreased health care utilization amongst patients experiencing homelessness. DISCUSSION/SIGNIFICANCE OF IMPACT: Providing care to patients experiencing homelessness involves working within complex social problems that cannot be adequately addressed in a hospital setting. This is best accomplished with an interdisciplinary team that extends the care continuum beyond hospital walls. The HHL program coordinators believe that ED visits amongst HHL patients and percentage of warm hand-offs are closely related outcomes. If we are able to facilitate a higher percentage of warm hand-offs to supportive social service agencies, we may be able to decrease patient reliance on the emergency department as a source of health care, meals, and warmth. Identifying the factors associated with successful warm hand-offs upon discharge from the hospital may assist us in building on the HHL program’s initial successes to further decrease health care utilization while offering increased interdisciplinary educational opportunities for medical students.

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The impact of COVID-19 on hospital admissions and emergency department visits: A population-based study

PLoS ONE ◽

10.1371/journal.pone.0252441 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252441

Author(s):

Elissa Rennert-May ◽

Jenine Leal ◽

Nguyen Xuan Thanh ◽

Eddy Lang ◽

Shawn Dowling ◽

...

Keyword(s):

Public Health ◽

Emergency Department ◽

Hospital Admissions ◽

Population Based ◽

Emergency Department Visits ◽

System Capacity ◽

Population Based Study ◽

Health Measures ◽

Ed Visits ◽

The Impact

Background As a result of the novel coronavirus disease 2019 (COVID-19), there have been widespread changes in healthcare access. We conducted a retrospective population-based study in Alberta, Canada (population 4.4 million), where there have been approximately 1550 hospital admissions for COVID-19, to determine the impact of COVID-19 on hospital admissions and emergency department (ED visits), following initiation of a public health emergency act on March 15, 2020. Methods We used multivariable negative binomial regression models to compare daily numbers of medical/surgical hospital admissions via the ED between March 16-September 23, 2019 (pre COVID-19) and March 16-September 23, 2020 (post COVID-19 public health measures). We compared the most frequent diagnoses for hospital admissions pre/post COVID-19 public health measures. A similar analysis was completed for numbers of daily ED visits for any reason with a particular focus on ambulatory care sensitive conditions (ACSC). Findings There was a significant reduction in both daily medical (incident rate ratio (IRR) 0.86, p<0.001) and surgical (IRR 0.82, p<0.001) admissions through the ED in Alberta post COVID-19 public health measures. There was a significant decline in daily ED visits (IRR 0.65, p<0.001) including ACSC (IRR 0.75, p<0.001). The most common medical/surgical diagnoses for hospital admissions did not vary substantially pre and post COVID-19 public health measures, though there was a significant reduction in admissions for chronic obstructive pulmonary disease and a significant increase in admissions for mental and behavioral disorders due to use of alcohol. Conclusions Despite a relatively low volume of COVID-19 hospital admissions in Alberta, there was an extensive impact on our healthcare system with fewer admissions to hospital and ED visits. This work generates hypotheses around causes for reduced hospital admissions and ED visits which warrant further investigation. As most publicly funded health systems struggle with health-system capacity routinely, understanding how these reductions can be safely sustained will be critical.

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The impact of closing emergency departments on mortality in emergencies: an observational study

Emergency Medicine Journal ◽

10.1136/emermed-2018-208146 ◽

2019 ◽

Vol 36 (11) ◽

pp. 645-651 ◽

Cited By ~ 5

Author(s):

Emma Knowles ◽

Neil Shephard ◽

Tony Stone ◽

Suzanne M Mason ◽

Jon Nicholl

Keyword(s):

Emergency Care ◽

Emergency Departments ◽

Hospital Admissions ◽

Geographical Area ◽

Case Fatality ◽

Urgent Care ◽

Mortality Data ◽

Risk Of Death ◽

Population Mortality ◽

The Impact

BackgroundIn England the demand for emergency care is increasing, while there is also a staffing shortage. This has implications for quality of care and patient safety. One solution may be to concentrate resources on fewer sites by closing or downgrading emergency departments (EDs). Our aim was to quantify the impact of such reorganisation on population mortality.MethodsWe undertook a controlled interrupted time series analysis to detect the impact of closing or downgrading five EDs, which occurred due to concerns regarding sustainability. We obtained mortality data from 2007 to 2014 using national databases. To establish ED resident catchment populations, estimated journey times by road were supplied by the Department for Transport. Other major changes in the emergency and urgent care system were determined by analysis of annual NHS Trust reports in each geographical area studied. Our main outcome measures were mortality and case fatality for a set of 16 serious emergency conditions.ResultsFor residents in the areas affected by closure, journey time to the nearest ED increased (median change 9 min, range 0–25 min). We found no statistically reliable evidence of a change in overall mortality following reorganisation of ED care in any of the five areas or overall (+2.5% more deaths per month on average; 95% CI −5.2% to +10.2%; p=0.52). There was some evidence to suggest that, on average across the five areas, there was a small increase in case fatality, an indicator of the ‘risk of death’ (+2.3%, 95% CI +0.9% to+3.6%; p<0.001), but this may have arisen due to changes in hospital admissions.ConclusionsWe found no evidence that reorganisation of emergency care was associated with a change in population mortality in the five areas studied. Further research should establish the economic consequences and impact on patient experience and neighbouring hospitals.

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Drug-Related Visits to the Emergency Department

Journal of Pharmacy Practice ◽

10.1177/0897190005280049 ◽

2005 ◽

Vol 18 (5) ◽

pp. 329-335 ◽

Cited By ~ 23

Author(s):

Peter J. Zed

Keyword(s):

Health Care ◽

Emergency Department ◽

Hospital Admissions ◽

Medical Attention ◽

Limited Information ◽

Current Health ◽

The Past ◽

Ed Visits ◽

Current Health Care System ◽

The Impact

Over the past few years, several published reports have addressed the problem of drug-related morbidity in various practice settings. Studies evaluating drug-related hospitalization have estimated that approximately 5% to 10% of all hospital admissions are drug related. Unfortunately, many of these studies have excluded patients seeking medical attention in the emergency department (ED) but not requiring hospital admission. Drug-related visits to the emergency department are a significant problem and contribute to overall pressures on our current health care system. Despite the limited information published regarding drug-related ED visits, several studies describe the impact of this issue. The purpose of this article is to review the current literature pertaining to the incidence, classification, severity, preventability, and economic impact of drug-related visits to the emergency department.

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The effect of the COVID pandemic lockdown measures on surgical emergencies: experience and lessons learned from a Greek tertiary hospital

World Journal of Emergency Surgery ◽

10.1186/s13017-021-00364-1 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Emmanouil Pikoulis ◽

Nikolaos Koliakos ◽

Dimitrios Papaconstantinou ◽

Nikolaos Pararas ◽

Andreas Pikoulis ◽

...

Keyword(s):

Emergency Departments ◽

Hospital Admissions ◽

Motor Vehicle ◽

Perianal Abscess ◽

Lessons Learned ◽

University Hospital ◽

Tertiary Referral Center ◽

Surgical Department ◽

Number Of Patients ◽

The Impact

Abstract Background The COVID-19 pandemic caused a rise in healthcare demands leading to significant restructuring of hospital emergency departments worldwide. The aim of the present study is twofold: firstly, to discern any differences in regard to reason for surgical emergency department (SED) attendance and hospital admission during the pandemic and pre-pandemic eras in Greece, and secondly, to assess the impact of the lockdown measures implemented during the pandemic on SED patient attendance. Methods Since the beginning of the COVID-19 pandemic in Greece (1 March 2020) and up to 15 December 2020, the charts of all adult patients arriving at the SED of the third surgical department of the “Attikon” University Hospital (a tertiary referral center for surgical and COVID-19 cases) were retrospectively reviewed and broken down in four periods reflecting two nationwide lockdown (period A 1/3/2020 to 30/4/2020 and period D 16/10/2020 to 15/12/2020) and two interim (period B 1/5/2020 to 15/6/2020 and period C 15/9/2020 to 30/10/2020) periods. Demographic and clinical data were compared to those obtained from the same time periods of the year 2019. Results The total number of patients attending the SED decreased by 35.9% during the pandemic (from 2839 total patients in 2019 to 1819 in 2020). During the first lockdown, there was statistically significant reduction of motor vehicle accidents (p=0.04) and torso injuries (p=0.01). Contrarily, the rate of head injuries (p<0.001) and abdominal pain (p=0.04) were significantly increased. The same effect was observed regarding the rate of hospital admissions (p=0.002), although in terms of absolute numbers, admissions remained unchanged. During the second lockdown, there was a reduction in the number of perianal abscess cases (p=0.04) and hernia-related problems (p=0.001). An increase in the rate of fall injuries was also demonstrable (p=0.02). Overall, application of the lockdown led to a significant decrease in minor (p<0.001) and torso (p=0.001) injuries. Conclusion The burden of the new COVID-19 disease has left a noticeable imprint in the function of emergency departments worldwide. In Greece, SED attendance was significantly reduced during the pandemic, an effect that was even more pronounced during the lockdown implementation; nevertheless, the overall rate of hospital admissions remained the same, denoting that patient care was not altered.

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