Madrid Emergency Medical Service (SUMMA 112), Spain.
Department of Neurology and Stroke Center, La Paz University Hospital, Universidad Autónoma de Madrid, IdiPAZ Research Institute, Spain.
Medicine (Baltimore). 2021 Oct 29;100(43):e27634. doi: 10.1097/MD.0000000000027634.
Acute sstroke is the most common time-dependent disease attended in the emergency medical service (EMS) of Madrid (SUMMA 112). Community of Madrid has been one of the most affected regions in Spain by the coronavirus disease 2019 (COVID-19) pandemic. A significant reduction in acute sstroke hospital admissions has been reported during the COVID-19 pandemic compared to the same period 1 year before. As international clinical practice guidelines support those patients with suspected acute stroke should be accessed via EMS, it is important to know whether the pandemic has jeopardized urgent pre-hospital stroke care, the first medical contact for most patients. We aimed to examine the impact of the COVID-19 in stroke codes (SC) in our EMS among 3 periods of time: the COVID-19 period, the same period the year before, and the 2019-2020 seasonal influenza period.We compared the SC frequency among the periods with high cumulative infection rate (above the median of the series) of the first wave of COVID-19, seasonal influenza, and also with the same period of the year before.One thousand one hundred thirty SC were attended during the 3 periods. No significant reduction in SC was found during the COVID-19 pandemic. The reduction of hospital admissions might be attributable to patients attending the hospital by their means. The maximum SC workload seen during seasonal influenza has not been reached during the pandemic. We detected a nonsignificant deviation from the SC protocol, with a slight increase in hospitals' transfers to hospitals without stroke units.
急性脑卒中是马德里紧急医疗服务（SUMMA 112）中最常见的时间依赖性疾病。马德里自治区是西班牙受 2019 年冠状病毒病（COVID-19）大流行影响最严重的地区之一。与 COVID-19 大流行前的同期相比，报告称 COVID-19 大流行期间急性脑卒中住院人数明显减少。由于国际临床实践指南支持对疑似急性脑卒中的患者应通过 EMS 进行评估，因此了解大流行是否危及大多数患者的紧急院前卒中护理（第一个医疗接触点）非常重要。我们旨在研究 COVID-19 对我们的 EMS 中的中风代码（SC）的影响，分为 3 个时间段：COVID-19 期间、前一年同期和 2019-2020 年季节性流感期间。我们比较了在 COVID-19 第一波、季节性流感的累积感染率（高于系列中位数）较高的时间段以及前一年同期的 SC 频率。在 3 个时期共处理了 1130 个 SC。在 COVID-19 大流行期间，SC 没有明显减少。住院人数减少可能归因于患者自行前往医院。大流行期间尚未达到季节性流感期间的 SC 工作量最大值。我们发现 SC 方案存在无显著偏差，将患者转移到无卒中单位的医院的情况略有增加。
