Brunssen Alicia, Rücker Viktoria, Heuschmann Peter, Held Jana, Hermanek Peter, Berlis Ansgar, Hecht Martin, Berger Klaus
Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.
Front Neurol. 2022 Jul 22;13:924271. doi: 10.3389/fneur.2022.924271. eCollection 2022.
At the beginning of the SARS-CoV-2 pandemic, an alarming decline in hospitalizations for stroke was reported in several countries, including Germany. We assessed hospitalization numbers and indicators of the quality of stroke care in 2020 during the pandemic containment measures.
The analysis was based on data of two large stroke quality assurance registries in the north and the south of Germany (Qualitätssicherung Schlaganfall Nordwestdeutschland and Bayerische Arbeitsgemeinschaft für Qualitätssicherung in der stationären Versorgung). We included 395 hospitals with 467,931 documented cases in 2018-2020. The time interval between admission and thrombolysis, frequency of systemic thrombolysis and intra-arterial therapy (IAT), National Institutes of Health Stroke Scale (NIHSS) score on admission and in-hospital mortality were assessed. Changes in the second (Q2) and fourth (Q4) quarters of 2020 were compared to corresponding quarters in 2019 by chi-squared tests.
Hospitalization numbers decreased in the two stroke registries by 8% and 10% in Q2 of 2020 and by 5% and 15% in Q4 of 2020 compared to the same quarters in 2019, respectively. The decline was particularly seen in women and patients with transient ischemic attacks. In cases with cerebral infarction, no increase in NIHSS scores on admission was observed, and the proportion of patients with a time interval between admission and thrombolysis of ≤60 min was unchanged. No clear pattern was found in the frequency of systemic thrombolysis and IAT. In one of the registries, in-hospital mortality of patients with cerebral infarction increased in Q2 of 2020 compared to Q2 of 2019.
Case numbers slightly decreased under pandemic conditions, while our quarterly analysis indicated that the quality of stroke care was largely unchanged throughout the year 2020.
在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行初期，包括德国在内的几个国家报告了中风住院人数令人担忧的下降情况。我们评估了2020年疫情防控措施期间中风护理的住院人数和质量指标。
该分析基于德国北部和南部两个大型中风质量保证登记处的数据（北德中风质量保证和巴伐利亚州住院治疗质量保证工作组）。我们纳入了395家医院，2018 - 2020年有467,931例记录病例。评估了入院至溶栓的时间间隔、全身溶栓和动脉内治疗（IAT）的频率、入院时的美国国立卫生研究院卒中量表（NIHSS）评分以及住院死亡率。通过卡方检验比较了2020年第二季度（Q2）和第四季度（Q4）与2019年相应季度的变化。
与2019年同期相比，两个中风登记处的住院人数在2020年第二季度分别下降了8%和10%，在2020年第四季度分别下降了5%和15%。这种下降在女性和短暂性脑缺血发作患者中尤为明显。在脑梗死病例中，入院时NIHSS评分没有增加，入院至溶栓时间间隔≤60分钟的患者比例没有变化。全身溶栓和IAT的频率没有发现明显模式。在其中一个登记处，2020年第二季度脑梗死患者的住院死亡率与2019年第二季度相比有所增加。
在大流行条件下病例数略有下降，而我们的季度分析表明，2020年全年中风护理质量基本保持不变。
