Böjti Péter Pál, Stang Rita, Gunda Bence, Sipos Ildikó, Bereczki Dániel
Általános Orvostudományi Kar, Neurológiai Klinika,Semmelweis Egyetem, Budapest, Balassa u. 6., 1083.
Neuroepidemiológiai Kutatócsoport,MTA-SE, Budapest.
Orv Hetil. 2020 Aug;161(34):1395-1399. doi: 10.1556/650.2020.31936.
Early international observations report decreased number of acute ischemic stroke admissions and prolonged onset-to-treatment times during COVID-19 pandemic.
Our goal was to assess the effect of COVID-19 pandemic on Hungarian acute ischemic stroke care.
We compared demographical and clinical characteristics, rate of intravenous and endovascular therapies and therapeutic time parameters of acute ischemic strokes admitted to a university stroke centre in a COVID-epidemic period (01/03/2020-30/04/2020) and an identical period of 2019.
86 patients were admitted during the COVID-period and 97 in the control period. Demographical and clinical characteristics of these periods were well-balanced. In the COVID-period, the proportion of patients arriving beyond 24 hours after onset increased by 13% (p = 0.046), the rate of endovascular interventions remained unchanged (8%), the rate of intravenous thrombolysis decreased from 26% to 16%, the mean onset-to-treatment time of thrombolysis increased by 20 minutes, while the mean door-to-treatment time increased by only 5 minutes. Behind the shift of arrival time categories, multivariable (year of examination, NIHSS, age) logistic regression shows that the year of examination might play a leading role (p = 0.096).
In the COVID-period, admissions for acute ischemic strokes decreased by 11% and the proportion of cases certainly untreatable by reperfusion therapies (arriving beyond 24 hours after onset) increased significantly. While the rate of endovascular interventions remained unchanged, the absolute rate of intravenous thrombolysis decreased by 10% and the mean onset-to-treatment time showed a tendency to increase. In these changes, the COVID-epidemic itself and related out-of-hospital factors might play a leading role. Orv Hetil. 2020; 161(34): 1395-1399.
早期国际观察报告称，在新冠疫情期间，急性缺血性中风入院人数减少，发病至治疗时间延长。
我们的目标是评估新冠疫情对匈牙利急性缺血性中风治疗的影响。
我们比较了在新冠疫情期间（2020年3月1日至2020年4月30日）和2019年同期入住一所大学中风中心的急性缺血性中风患者的人口统计学和临床特征、静脉和血管内治疗率以及治疗时间参数。
新冠疫情期间有86例患者入院，对照期间有97例。这两个时期的人口统计学和临床特征均衡。在新冠疫情期间，发病后24小时以上就诊的患者比例增加了13%（p = 0.046），血管内介入治疗率保持不变（8%），静脉溶栓率从26%降至16%，溶栓的平均发病至治疗时间增加了20分钟而平均门到治疗时间仅增加了5分钟。在就诊时间类别变化背后，多变量（检查年份、美国国立卫生研究院卒中量表评分、年龄）逻辑回归显示检查年份可能起主导作用（p = 0.096）。
在新冠疫情期间，急性缺血性中风入院人数减少了11%，肯定无法通过再灌注治疗（发病后24小时以上就诊）的病例比例显著增加。虽然血管内介入治疗率保持不变，但静脉溶栓的绝对率下降了10%，平均发病至治疗时间呈增加趋势。在这些变化中，新冠疫情本身及相关院外因素可能起主导作用。《匈牙利医学周报》。2020年；161(34): 1395 - 1399。
