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COVID-19 大流行期间介入性中风设备使用的趋势。

Trends in interventional stroke device utilization during the COVID-19 pandemic.

机构信息

School of Medicine, University of Michigan, Ann Arbor, MI, USA.

ProMedica Neurosciences Institute, Toledo, OH, USA; Department of Neurology, University of Toledo, Toledo, OH, USA.

出版信息

Clin Neurol Neurosurg. 2021 Oct;209:106931. doi: 10.1016/j.clineuro.2021.106931. Epub 2021 Sep 2.

Abstract

OBJECTIVES

The collateral effect of the COVID-19 pandemic on interventional stroke care is not well described. We studied this effect by utilizing stroke device sales data as markers of interventional stroke case volume in the United States.

METHODS

Using a real-time healthcare device sales registry, this observational study examined trends in the sales of thrombectomy devices and cerebral aneurysm coiling from the same 945 reporting hospitals in the U.S. between January 22 and June 31, 2020, and for the same months in 2018 and 2019 to allow for comparison. We simultaneously reviewed daily reports of new COVID-19 cases. The strength of association between the cumulative incidence of COVID-19 and procedural device sales was measured using Spearman rank correlation coefficient (CC).

RESULTS

Device sales decreased for thrombectomy (- 3.7%) and cerebral aneurysm coiling (- 8.5%) when comparing 2019-2020. In 2020, thrombectomy device sales were negatively associated with the cumulative incidence of COVID-19 (CC - 0.56, p < 0.0001), with stronger negative correlation during April (CC - 0.97, p < 0.0001). The same negative correlation was observed with aneurysm treatment devices (CC - 0.60, p < 0.001), with stronger correlation in April (CC - 0.97, p < 0.0001).

CONCLUSIONS

The decline in sales of stroke interventional equipment underscores a decline in associated case volumes. Future pandemic responses should consider strategies to mitigate such negative collateral effects.

摘要

目的

COVID-19 大流行对介入性脑卒中治疗的间接影响尚不清楚。本研究通过利用脑卒中设备销售数据来评估美国介入性脑卒中病例量的变化,以此研究这一影响。

方法

本观察性研究使用实时医疗设备销售登记处,分析了 2020 年 1 月 22 日至 6 月 31 日期间,美国 945 家报告医院中取栓设备和脑动脉瘤弹簧圈的销售趋势,并与 2018 年和 2019 年同期进行比较,以便进行比较。同时,我们审查了每日新增 COVID-19 病例报告。采用 Spearman 秩相关系数(CC)衡量 COVID-19 累计发病率与手术设备销售之间的关联强度。

结果

与 2019-2020 年相比,取栓术(-3.7%)和脑动脉瘤弹簧圈术(-8.5%)的设备销售量下降。2020 年,取栓设备销售与 COVID-19 的累计发病率呈负相关(CC-0.56,p<0.0001),4 月相关性更强(CC-0.97,p<0.0001)。与动脉瘤治疗设备也存在相同的负相关关系(CC-0.60,p<0.001),4 月相关性更强(CC-0.97,p<0.0001)。

结论

脑卒中介入设备销售额下降表明相关病例量减少。未来的大流行应对措施应考虑制定策略以减轻这种负面影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/115c/8411657/91db00590655/gr1_lrg.jpg

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