Ohara Nobuyuki, Imamura Hirotoshi, Adachi Hidemitsu, Hara Yoshie, Hosoda Kohkichi, Kimura Hidehito, Kuwayama Kazuyuki, Mizowaki Takashi, Motooka Yasuhiko, Nakashima Kazuya, Shinoda Narihide, Takamoto Takeshi, Ueno Yasushi, Yamaura Ikuya, Yanagihara Chie, Yoshida Yasuhisa, Kawamoto Michi, Sakai Nobuyuki
Department of Neurology, Kobe City Medical Center General Hospital, Kobe, Japan.
Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan.
J Stroke Cerebrovasc Dis. 2020 Dec;29(12):105343. doi: 10.1016/j.jstrokecerebrovasdis.2020.105343. Epub 2020 Sep 30.
The novel coronavirus disease 2019 (COVID-19) outbreak raised concerns over healthcare systems' ability to provide suitable care to stroke patients. In the present study, we examined the provision of stroke care in Kobe City during the COVID-19 epidemic, where some major stroke centers ceased to provide emergency care.
This was a cross-sectional study. The Kobe Stroke Network surveyed the number of stroke patients admitted to all primary stroke centers (PSCs) in the city between March 1 and May 23, 2020, and between March 3 and May 25, 2019. In addition, online meetings between all PSC directors were held regularly to share information. The survey items included emergency response system characteristics, number of patients with stroke hospitalized within 7 days of onset, administered treatment types (IV rt-PA, mechanical thrombectomy, surgery, and endovascular therapy), and stroke patients with confirmed COVID-19.
During the period of interest in 2020, the number of stroke patients hospitalized across 13 PSCs was 813, which was 15.5% lower than that during the same period of 2019 (p = 0.285). The number of patients admitted with cerebral infarction, intracerebral hemorrhage, and subarachnoid hemorrhage decreased by 15.4% (p = 0.245), 16.1% (p = 0.659), and 14.0% (p = 0.715), respectively. However, the rates of mechanical thrombectomy and surgery for intracerebral hemorrhage were slightly increased by 12.1% (p = 0.754) and 5.0% (p = 0.538), respectively. PSCs that ceased to provide emergency care reported a decrease in the number of stroke cases of 65.7% compared with the same period in 2019, while other PSCs reported an increase of 0.8%. No case of a patient with stroke and confirmed COVID-19 was reported during the study period.
Kobe City was able to maintain operation of its stroke care systems thanks to close cooperation among all city PSCs and a temporal decrease in the total number of stroke cases.
2019年新型冠状病毒病（COVID-19）疫情引发了人们对医疗系统为中风患者提供适当护理能力的担忧。在本研究中，我们调查了COVID-19疫情期间神户市的中风护理情况，当时一些主要的中风中心停止了提供急诊服务。
这是一项横断面研究。神户中风网络调查了2020年3月1日至5月23日以及2019年3月3日至5月25日期间该市所有初级中风中心（PSC）收治的中风患者数量。此外，PSC主任之间定期举行线上会议以分享信息。调查项目包括应急系统特征、发病7天内住院的中风患者数量、所给予的治疗类型（静脉注射重组组织型纤溶酶原激活剂、机械取栓术、手术和血管内治疗）以及确诊为COVID-19的中风患者。
在2020年的相关时期内，13个PSC收治的中风患者数量为813例，比2019年同期减少了15.5%（p = 0.285）。脑梗死、脑出血和蛛网膜下腔出血患者的入院人数分别减少了15.4%（p = 0.245）、16.1%（p = 0.659）和14.0%（p = 0.715）。然而，机械取栓术和脑出血手术的比例分别略有增加，增加了12.1%（p = 0.754）和5.0%（p = 0.538）。停止提供急诊服务的PSC报告称，中风病例数比2019年同期减少了65.7%，而其他PSC报告增加了0.8%。研究期间未报告中风患者确诊COVID-19的病例。
由于该市所有PSC之间的密切合作以及中风病例总数的暂时减少，神户市得以维持其中风护理系统的运作。
