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COVID-19 大流行对疑似急性脑卒中患者院前管理的影响:一项回顾性队列研究。

Effect of the COVID-19 Pandemic in the Prehospital Management of Patients with Suspected Acute Stroke: A Retrospective Cohort Study.

机构信息

Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy in Warsaw, 03-411 Warsaw, Poland.

Department of Neurology, Wolski Hospital, 01-211 Warsaw, Poland.

出版信息

Int J Environ Res Public Health. 2022 Apr 14;19(8):4769. doi: 10.3390/ijerph19084769.

Abstract

Acute Ischemic Stroke (AIS) can be successfully handled if it is noticed early in the prehospital setting and immediately diagnosed in the emergency department (ED). The coronavirus pandemic has altered the way health care is delivered and has had a profound impact on healthcare delivery. The effects could include prioritizing the prevention of COVID-19 spread, which could result in the discontinuation or deferral of non-COVID-19 care. We used the National Emergency Medical Service Command Support System, a register of medical interventions performed by emergency medical services (EMS) in Poland, to assess the impact of the COVID-19 epidemic across the Masovian Voivodeship on suspected stroke patients' baseline characteristics, prehospital vital parameters, clinical and neurological status, emergency procedures performed on the prehospital phase and EMS processing times. Between 1 April 2019 and 30 April 2021, the study population included 18,922 adult suspected stroke patients who were treated by EMS teams, with 18,641 admitted to the emergency departments. The overall number of suspected stroke patients treated by EMS remained unchanged during COVID-19 compared to the pre-COVID-19 period; however, the average time from call to hospital admission increased by 15 min.

摘要

急性缺血性脑卒中(AIS)如果在院前阶段及早发现,并在急诊科(ED)立即诊断,可得到成功处理。冠状病毒大流行改变了医疗服务的提供方式,对医疗服务的提供产生了深远的影响。这些影响可能包括优先预防 COVID-19 的传播,这可能导致非 COVID-19 护理的中断或延迟。我们使用国家紧急医疗服务指挥支持系统,这是一个记录在波兰由紧急医疗服务(EMS)进行的医疗干预的登记册,来评估 COVID-19 疫情在马佐夫舍省对疑似脑卒中患者的基线特征、院前生命参数、临床和神经状态、在院前阶段进行的紧急程序以及 EMS 处理时间的影响。在 2019 年 4 月 1 日至 2021 年 4 月 30 日期间,研究人群包括 18922 名接受 EMS 团队治疗的成年疑似脑卒中患者,其中 18641 名被收入急诊部。与 COVID-19 前相比,EMS 治疗的疑似脑卒中患者总数在 COVID-19 期间保持不变;然而,从呼叫到入院的平均时间增加了 15 分钟。

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