Ota Takahiro, Shiokawa Yoshiaki, Hirano Teruyuki
Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Fuchu, Japan.
Department of Neurosurgery, Kyorin University, Mitaka, Japan.
Front Neurol. 2020 Nov 30;11:601652. doi: 10.3389/fneur.2020.601652. eCollection 2020.
This study aimed to assess the number of patients with acute stroke seeking medical emergency care since the declaration of the state of emergency in the COVID-19 pandemic in the Tokyo metropolitan area of Japan. In this combined retrospective and prospective multicenter survey, data on the numbers of hospital admissions due to acute ischemic stroke, of large vessel occlusion (LVO) cases, and of reperfusion therapies performed from February to July 2020, restrictions of the medical care system, and comprehensive stroke center (CSC) scale scores were collected in 19 stroke centers in Tokyo. In the survey period, 3,456 patients were admitted with acute stroke. There was a decrease in the number of admissions (-22%), LVO (-22%), thrombolysis (-6%), and thrombectomy (-23%) during the state of emergency, but the ratio of thrombectomy to LVO cases was not different. The acceptance of acute stroke cases by emergency transport and emergent operations in the central eastern area of Tokyo, was also significantly decreased to <50% and remains <60%. According to CSC scores, each hospital restricted their infrastructure or educational activities according to their medical resources. There was only one stroke case with COVID-19 (thrombectomy case) in all 3,456 patients in this study. The COVID-19 pandemic had a major impact on stroke care in Tokyo, including stroke admissions and medical care systems, resulting in a significant reduction in thrombolysis and thrombectomy. The extent of the drop may be the result of the number of COVID-19 patients.
本研究旨在评估自日本东京都宣布进入新冠疫情紧急状态以来，寻求紧急医疗护理的急性中风患者数量。在这项回顾性和前瞻性相结合的多中心调查中，收集了东京19家中风中心2020年2月至7月期间急性缺血性中风的住院人数、大血管闭塞（LVO）病例数、所实施的再灌注治疗数据、医疗系统限制以及综合中风中心（CSC）规模评分。在调查期间，有3456例急性中风患者入院。紧急状态期间，住院人数（-22%）、LVO病例数（-22%）、溶栓治疗（-6%）和血栓切除术（-23%）均有所下降，但血栓切除术与LVO病例的比例没有差异。东京中东部地区通过紧急转运和急诊手术接收急性中风病例的比例也显著下降至<50%，且仍<60%。根据CSC评分，各医院根据其医疗资源限制了基础设施或教育活动。本研究的3456例患者中仅有1例中风患者感染新冠病毒（血栓切除术病例）。新冠疫情对东京的中风护理产生了重大影响，包括中风入院情况和医疗系统，导致溶栓和血栓切除术显著减少。下降幅度可能是新冠患者数量所致。
