Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan.
Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.
Public Health. 2023 May;218:176-179. doi: 10.1016/j.puhe.2023.03.006. Epub 2023 Mar 14.
The COVID-19 pandemic placed an enormous strain on healthcare systems and raised concerns for delays in the management of patients with acute cerebrovascular events. In this study, we investigated cerebrovascular excess deaths in Japan.
Vital mortality statistics from January 2012 to May 2022 were obtained from the Japanese Ministry of Health, Labour and Welfare.
Using quasi-Poisson regression models, we estimated the expected weekly number of cerebrovascular deaths in Japan from January 2020 through May 2022 by place of death. Estimates were calculated for deaths in all locations, as well as for deaths in hospitals, in geriatric health service facilities, and at home. The age subgroups of ≥75 and <75 years were also considered. Weeks with a statistically significant excess of cerebrovascular deaths were determined when the weekly number of observed deaths exceeded the upper bound of 97.5% prediction interval.
Excess deaths were noted in June 2021 and became more pronounced from February 2022 onward. The trend was notable among those aged ≥75 years and for those who died in hospitals. With respect to the location of deaths, the excess was significant in geriatric health services facilities from April 2020 to June 2021, whereas no evidence of excess hospital deaths was observed during the same period.
Beginning in the late 2021, excess cerebrovascular deaths coincided with the spread of the Omicron variant and may be associated with increased healthcare burden. In 2020, COVID-19 altered the geography of cerebrovascular deaths, with fewer people dying in hospitals and more dying in geriatric health service facilities and at home.
新冠疫情给医疗系统带来了巨大压力，人们担心急性脑血管病患者的治疗会因此延误。本研究旨在调查日本的脑血管超额死亡情况。
从日本厚生劳动省获取了 2012 年 1 月至 2022 年 5 月的生命统计死亡率数据。
采用拟泊松回归模型，根据死亡地点，估算了日本 2020 年 1 月至 2022 年 5 月每周脑血管死亡的预期人数。估算了所有地点、医院、老年保健设施和家中的死亡人数。还考虑了年龄在 75 岁及以上和<75 岁的亚组。当观察到的每周死亡人数超过 97.5%预测区间上限时，确定存在具有统计学意义的脑血管超额死亡的周数。
2021 年 6 月出现超额死亡，从 2022 年 2 月开始，这一趋势变得更加明显。这一趋势在 75 岁及以上人群和医院死亡者中更为显著。就死亡地点而言，2020 年 4 月至 2021 年 6 月，老年保健设施的死亡人数出现了明显的超额，而同期并未观察到医院死亡人数的超额。
自 2021 年末以来，脑血管超额死亡与奥密克戎变异株的传播同时发生，可能与医疗负担增加有关。2020 年，COVID-19 改变了脑血管死亡的地理分布，死于医院的人数减少，死于老年保健设施和家中的人数增加。
