Rosales Julieta S, Rodriguez-Perez María Soledad, Ameriso Sebastián F
División de Neurología Vascular, Departamento de Neurología, FLENI, Buenos Aires, Argentina. E-mail:
División de Neurología Vascular, Departamento de Neurología, FLENI, Buenos Aires, Argentina.
Medicina (B Aires). 2020;80 Suppl 6:65-70.
The COVID-19 pandemic and preventive and compulsory social isolation (PCSI) have generated changes in the organization and use of the health system around the world. We analyze the impact of the health situation on the number of outpatient visits, hospitalizations and access to revascularization therapy for cerebrovascular disease. The period from March 1 to July 31, 2020 was analyzed. It was compared with the same period in 2019. Total outpatient and hospital visits were evaluated, NIHSS scale (National Institute of Health Stroke Scale) upon admission, type of cerebrovascular disease and use of revascularization therapies; 197 patients with acute cerebrovascular events were admitted in 2019 and 150 patients in 2020. There was a significant decrease in the number of hospitalizations for total ischemic events and transient ischemic attacks in the comparison of 5 months. An increase in cerebral venous thrombosis and cerebral hemorrhages was also seen. Access to intravenous fibrinolysis and mechanical thrombectomy remained stable, but with prolonged door-to-needle time. Outpatient visits fell 67%, the decrease being greater in April and more marked in follow-up visits. The number of hospitalizations and outpatient visits during the PCSI dropped substantially. This seems to be due to strict compliance with quarantine and not to pathophysiological mechanisms related to COVID-19. The population should be educated about the need to control chronic diseases and acute events and safety measures should be guaranteed in health centers.
新冠疫情以及预防性和强制性社会隔离措施(PCSI)已使全球卫生系统的组织和使用发生了变化。我们分析了健康状况对门诊就诊次数、住院情况以及脑血管疾病血管再通治疗可及性的影响。分析了2020年3月1日至7月31日这一时期,并与2019年同期进行了比较。评估了门诊和住院总人次、入院时的美国国立卫生研究院卒中量表(NIHSS)评分、脑血管疾病类型以及血管再通治疗的使用情况;2019年有197例急性脑血管事件患者入院,2020年有150例。在5个月的比较中,总缺血性事件和短暂性脑缺血发作的住院人数显著减少。脑静脉血栓形成和脑出血也有所增加。静脉溶栓和机械取栓的可及性保持稳定,但从入院到开始治疗的时间延长。门诊就诊量下降了67%,4月份下降幅度更大,随访就诊时更为明显。PCSI期间的住院人数和门诊就诊量大幅下降。这似乎是由于严格遵守隔离措施,而非与新冠病毒相关的病理生理机制所致。应向民众宣传控制慢性病和急性事件的必要性,并应确保医疗中心的安全措施。