Department of Neurosurgery, Juntendo University Nerima Hospital, Takanodai 3-1-10, Nerima, Tokyo, 177-8521, Japan.
School of Commerce, Waseda University, Nishi-Waseda 1-6-1, Shinjuku, Tokyo, 169-8050, Japan.
Acta Neurol Belg. 2023 Apr;123(2):399-406. doi: 10.1007/s13760-022-01979-0. Epub 2022 May 26.
The coronavirus disease 2019 (COVID-19) pandemic has caused a global public health crisis and profoundly impacted acute treatment delivery. This study conducted long-term evaluations of the impact of the pandemic on acute stroke management.
Data from a university-owned medical facility in Tokyo, Japan, were retrospectively analyzed. The number of hospital admissions for stroke and time metrics in the management of patients with acute ischemic stroke were evaluated. A year-over-year comparison was conducted using data from April 2019 to December 2021 to assess the impact of the pandemic.
The year-over-year comparison demonstrated that the number of admissions of patients with stroke and patients who underwent magnetic resonance imaging (MRI), intravenous recombinant tissue plasminogen activator (rt-PA), and thrombectomy during the pandemic remained comparable to the pre-COVID data. However, we found a decrease in the number of admissions of patients with stroke alerts and stroke when hospital cluster infection occurred at this facility and when the region hosted the Tokyo Olympics games during the surge of infection. The door-to-computed tomography time in 2021 was affected. This is plausibly due to the reorganization of in-hospital stroke care pathways after hospital cluster infection. However, no significant difference was observed in the onset-to-door, door-to-MRI, door-to-needle, or door-to-groin puncture times.
We did not observe long-term detrimental effects of the pandemic at this site. Prevention of hospital cluster infections remains critical to provide safe and timely acute stroke management during the pandemic.
2019 年冠状病毒病（COVID-19）大流行造成了全球公共卫生危机，并对急性治疗服务产生了深远影响。本研究对大流行对急性脑卒中管理的影响进行了长期评估。
对日本东京一所大学附属医院的数据进行回顾性分析。评估了脑卒中患者的住院人数和急性缺血性脑卒中患者管理的时间指标。使用 2019 年 4 月至 2021 年 12 月的数据进行年度比较，以评估大流行的影响。
年度比较表明，在大流行期间，脑卒中患者和接受磁共振成像（MRI）、静脉重组组织型纤溶酶原激活剂（rt-PA）和血栓切除术的患者的住院人数与 COVID 前数据相比保持相当。然而，我们发现当该设施发生医院集群感染以及当该地区举办东京奥运会期间感染激增时，脑卒中警报和脑卒中患者的住院人数减少。2021 年的门到计算机断层扫描时间受到影响。这可能是由于医院集群感染后对院内脑卒中治疗途径进行了重组。然而，发病到门、门到 MRI、门到针或门到腹股沟穿刺的时间没有观察到显著差异。
在本研究地点未观察到大流行的长期不利影响。预防医院集群感染仍然是在大流行期间提供安全和及时的急性脑卒中管理的关键。
