Lin Gangqiang, Xu Xueqian, Luan Xiaoqian, Qiu Huihua, Shao Shengfang, Wu Qingsong, Xu Wei, Huang Guiqian, He Jincai, Feng Liang
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Front Neurol. 2022 Apr 18;13:873061. doi: 10.3389/fneur.2022.873061. eCollection 2022.
Globally, intracerebral hemorrhage (ICH) is a common cerebrovascular disease. At the beginning of 2020, due to the coronavirus disease 2019 (COVID-19) pandemic, the allocation of medical resources and the patient treatment and referrals were affected to varying degrees. We aimed to determine the characteristics and prognoses and associated factors of patients with ICH.
The baseline demographic characteristics and ICH outcomes were compared between patients diagnosed with ICH between January and June 2020 (the 2020 group) and between January and June 2019 (the 2019 group). COVID-19 positive patients were excluded from the study. A 30-day data from patients in the 2019 and 2020 groups were analyzed to create survival curves for these patients. We also used regression models to identify the significant determinants of poor outcomes [modified Rankin score (mRS): 3-6] and death.
The number of patients diagnosed with ICH was slightly lower in the 2020 group ( = 707) than in the 2019 group ( = 719). During the lockdown period (February 2020), the admission rates for ICH decreased greatly by 35.1%. The distribution of the patients' domicile ( = 0.002) and the mRS ( < 0.001) differed significantly between the years. The survival curve revealed that the highest risk of death was in the acute stage (especially in the first 5 days) of ICH. At 30 days, mortality was 19.8% in February 2019 and 29.4% in February 2020 ( = 0.119). Multivariate analysis revealed age, baseline mRS, postoperative complications, massive brainstem hemorrhage, and creatinine as factors significantly associated with poor outcomes and death following ICH. Neurosurgery and massive supratentorial hemorrhage were only correlated with the risk of death.
During the lockdown period, the COVID-19 pandemic caused a decrease in the admission rates and severe conditions at admission due to strict traffic constraints for infection control. This led to high mortality and disability in patients with ICH. It is necessary to ensure an effective green channel and allocate adequate medical resources for patients to receive timely treatment and neurosurgery.
在全球范围内，脑出血（ICH）是一种常见的脑血管疾病。2020年初，由于2019冠状病毒病（COVID-19）大流行，医疗资源的分配以及患者的治疗和转诊受到了不同程度的影响。我们旨在确定脑出血患者的特征、预后及相关因素。
比较2020年1月至6月（2020组）和2019年1月至6月（2019组）诊断为脑出血的患者的基线人口统计学特征和脑出血结局。COVID-19阳性患者被排除在研究之外。分析2019组和2020组患者的30天数据，为这些患者绘制生存曲线。我们还使用回归模型来确定不良结局[改良Rankin量表（mRS）：3 - 6]和死亡的显著决定因素。
2020组诊断为脑出血的患者数量（ = 707）略低于2019组（ = 719）。在封锁期间（2020年2月），脑出血的入院率大幅下降了3（此处原文有误，应为35.1%）5.1%。不同年份患者的住所分布（ = 0.002）和mRS（ < 0.001）存在显著差异。生存曲线显示，脑出血急性期（尤其是前5天）死亡风险最高。在30天时，2019年2月的死亡率为19.8%，2020年2月为29.4%（ = 0.119）。多因素分析显示，年龄、基线mRS、术后并发症、大量脑干出血和肌酐是与脑出血后不良结局和死亡显著相关的因素。神经外科手术和大量幕上出血仅与死亡风险相关。
在封锁期间（此处原文有误，应为“在封锁期间”），COVID-19大流行由于严格的交通限制以控制感染，导致入院率下降以及入院时病情严重。这导致脑出血患者的高死亡率和残疾率。有必要确保有效的绿色通道，并为患者分配足够的医疗资源，以便他们能够及时接受治疗和神经外科手术。
