Institute of Medicine, Opole University, Poland.
Neurosurgery Department, Medical University of Gdansk, Poland.
Neurol Neurochir Pol. 2022;56(1):96-100. doi: 10.5603/PJNNS.a2022.0006. Epub 2022 Jan 11.
The COVID-19 pandemic greatly disrupted the national healthcare system in Poland, resulting in the implementation of new protocols allowing only patients with severe diagnoses to receive immediate treatment. Given that an intracranial aneurysm (IA) is regarded as one of the most severe diagnoses, we planned to assess whether the current protocol has successfully provided the standard treatment for IAs.
Data on all IA cases treated from 2015 to 2020 was extracted from the JGP (a homogeneous group of patients) catalogue provided by the National Health Index of Poland (NFZ, Narodowy Fundusz Zdrowia). Poisson regression was used to determine the significance of the change in hospital admissions, and differences between proportions were analysed using the "N-1" Chi-squared test.
A total of 21,801 IA patients treated during 2015-2020 were included in this study. The overall number of hospitalisations due to IAs fell in the open surgery group, but not in the endovascular cohort. Mortality rates following IA treatment increased significantly by 21% in 2020 compared to preceding years. The demographics changed as well; the patients were significantly younger during the pandemic.
Our findings show that the current strategy for optimal care for patients diagnosed with IAs in Poland during the pandemic is failing to maintain high quality treatment. New methods to improve the current plan should be implemented to address future crises.
COVID-19 大流行极大地扰乱了波兰的国家医疗体系，导致实施了新的协议，只允许严重诊断的患者立即接受治疗。鉴于颅内动脉瘤 (IA) 被认为是最严重的诊断之一，我们计划评估当前的协议是否成功为 IA 提供了标准治疗。
从波兰国家卫生指数 (NFZ，Narodowy Fundusz Zdrowia) 提供的 JGP（同质患者群体）目录中提取了 2015 年至 2020 年期间治疗的所有 IA 病例的数据。使用泊松回归来确定医院入院人数变化的显著性，并使用“N-1”卡方检验分析比例之间的差异。
本研究共纳入 2015-2020 年期间治疗的 21,801 例 IA 患者。开放手术组的 IA 总住院人数下降，但血管内组则没有。与前几年相比，2020 年 IA 治疗后的死亡率显著增加了 21%。人口统计学数据也发生了变化；大流行期间患者明显更年轻。
我们的研究结果表明，波兰大流行期间为确诊 IA 患者提供最佳治疗的当前策略未能维持高质量的治疗。应实施新的方法来改进当前计划，以应对未来的危机。
