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COVID-19 大流行对马佐夫舍省卒中入院人数和卒中介入治疗质量的影响。

Effect of COVID-19 pandemic on stroke admissions and quality of stroke interventional treatment in Masovian Voivodeship.

机构信息

Clinic of Neurology, Military Institute of Medicine, Szaserów 128, 04-141 Warsaw, Poland.

Department of Neurology with Stroke Unit, John Paul II Western Hospital, Daleka 11, 05-825 Grodzisk Mazowiecki, Poland.

出版信息

Neurol Neurochir Pol. 2021;55(2):223-226. doi: 10.5603/PJNNS.a2021.0025. Epub 2021 Mar 30.

Abstract

AIM OF STUDY

To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on the pathway of stroke interventional services and major quality indicators of stroke reperfusion therapies in Masovian Voivodeship.

MATERIALS AND METHODS

An exploratory retrospective analysis was performed at two comprehensive stroke centres to assess changes in stroke care between the early phase of the COVID-19 pandemic (weeks 10-18 of 2020) and the same period in 2019.

RESULTS

Of the 419 included stroke patients, 186 (44.4%) presented during the COVID-19 period. There was an increase in in-hospital delays for reperfusion therapies, and a significant decrease in the number of acute cerebrovascular accident admissions, predominantly related to a low number of transient ischaemic attack (TIA) admissions to hospital (-20.17%). The delays were shorter in the mothership paradigm than in the drip-and-ship paradigm of acute stroke care (onset-to-groin 293 vs. 232 min, p = 0.03). No differences in stroke aetiology, large-vessel occlusion frequency, or severe stroke admissions in the COVID-19 period were observed.

CONCLUSIONS AND CLINICAL IMPLICATIONS

COVID-19's emergence was correlated with a significant reduction in admissions to stroke departments, particularly for TIAs, and a prolonged delay in reperfusion stroke treatment, especially in the drip-and-ship paradigm. An educational campaign to raise public awareness of TIA and/or stroke symptoms and immediate reorganisation of stroke care during the COVID-19 era are necessary.

摘要

研究目的

评估 2019 年冠状病毒病(COVID-19)大流行对马佐夫舍省中风介入服务途径和中风再灌注治疗主要质量指标的影响。

材料和方法

在两家综合卒中中心进行了探索性回顾性分析,以评估 COVID-19 大流行早期(2020 年第 10-18 周)和 2019 年同期之间的卒中护理变化。

结果

在纳入的 419 例卒中患者中,186 例(44.4%)在 COVID-19 期间出现。再灌注治疗的院内延迟增加,急性脑血管意外入院数量显著减少,主要与短暂性脑缺血发作(TIA)入院数量减少有关(-20.17%)。母船模式下的延迟时间短于急性卒中护理的点滴输送模式(发病至腹股沟 293 分钟 vs. 232 分钟,p = 0.03)。在 COVID-19 期间,卒中病因、大血管闭塞频率或重症卒中入院方面没有差异。

结论和临床意义

COVID-19 的出现与卒中部门入院人数的显著减少相关,特别是 TIA,以及再灌注卒中治疗的延迟时间延长,尤其是在点滴输送模式下。有必要开展公众对 TIA 和/或卒中症状的认识教育活动,并在 COVID-19 期间对卒中护理进行即时重新组织。

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