Abdulazim Amr, Ebert Anne, Etminan Nima, Szabo Kristina, Alonso Angelika
Department of Neurosurgery, Medical Faculty Mannheim, Mannheim Center for Translational Neurosciences, Heidelberg University, Heidelberg, Germany.
Department of Neurology, Medical Faculty Mannheim, Mannheim Center for Translational Neurosciences, Heidelberg University, Heidelberg, Germany.
Front Neurol. 2020 Sep 18;11:584522. doi: 10.3389/fneur.2020.584522. eCollection 2020.
The COVID-19 pandemic has seriously impacted healthcare systems worldwide. Admissions for various non-COVID-19 emergencies have significantly decreased. We sought to determine the impact of COVID-19 on admissions for intracranial hemorrhage to a German University Hospital emergency department. In a retrospective analysis of admissions to the emergency department of the University Hospital Mannheim from January to June 2020 and the corresponding time period in 2019, all patients admitted for either traumatic or non-traumatic intracranial hemorrhage were evaluated. Poisson regression was performed to analyze changes in admission rates as a function of year, epoch (COVID-19-epoch, March to April 2020 and corresponding months 2019; non-COVID-19-epoch, January to February and May to June 2019/2020) and the interaction of year and epoch (reflecting the impact of the pandemic and subsequent lockdown measures). Overall, 320 patients were included in the study. During the COVID-19-epoch, admission rates for spontaneous intracranial hemorrhage decreased significantly by 42.1% (RR 0.579, = 0.002, 95% confidence interval 0.410-0.818). Likewise, admission rates for traumatic intracranial hemorrhage decreased significantly by 53.7% [RR = 0.463, < 0.001, 95% confidence interval (CI) 0.358-0.599]. The decrease of spontaneous intracranial hemorrhages may be a consequence of underutilization of the healthcare system whereas decreasing rates of traumatic intracranial hemorrhage admissions may predominantly reflect a decrease in true incidence rates due to lockdown measures with restricted mobility. Raising patient awareness to seek emergency healthcare for acute neurological deficits during lockdown measures is important to ensure appropriate emergency care for patients with intracranial hemorrhage.
新冠疫情严重影响了全球医疗系统。各类非新冠急症的入院人数显著减少。我们试图确定新冠疫情对德国一家大学医院急诊科颅内出血入院情况的影响。在对曼海姆大学医院急诊科2020年1月至6月以及2019年相应时间段的入院病例进行回顾性分析时，对所有因创伤性或非创伤性颅内出血入院的患者进行了评估。采用泊松回归分析入院率随年份、时期（新冠时期，2020年3月至4月以及2019年相应月份；非新冠时期，2019年/2020年1月至2月以及5月至6月）以及年份与时期的交互作用（反映疫情及随后封锁措施的影响）的变化情况。总体而言，320名患者纳入了该研究。在新冠时期，自发性颅内出血的入院率显著下降了42.1%（相对风险0.579，P = 0.002，95%置信区间0.410 - 0.818）。同样，创伤性颅内出血的入院率显著下降了53.7%[相对风险 = 0.463，P < 0.001，95%置信区间（CI）0.358 - 0.599]。自发性颅内出血的减少可能是医疗系统利用不足的结果，而创伤性颅内出血入院率的下降可能主要反映了由于行动受限的封锁措施导致真实发病率的降低。提高患者在封锁措施期间因急性神经功能缺损寻求紧急医疗护理的意识，对于确保颅内出血患者获得适当的紧急护理非常重要。
