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战争对乌克兰伊万诺-弗兰科夫斯克市卒中发病率的影响。

Impact of war on stroke incidence in Ivano-Frankivsk, Ukraine.

机构信息

Department of Human Anatomy, Ivano-Frankivsk National Medical University, Halytska 2, Ivano-Frankivsk, 76018, Ukraine.

Ivano-Frankivsk Central City Clinical Hospital, Mazepy 114, Ivano-Frankivsk, 76018, Ukraine.

出版信息

Sci Rep. 2024 Aug 16;14(1):18996. doi: 10.1038/s41598-024-70270-4.

Abstract

Stroke is an extensive health problem in Ukraine, the prominence and effects of which are aggravated by the burden of the ongoing Russo-Ukrainian War. In this study, we aimed to holistically examine the overall stroke epidemiology in Ivano-Frankivsk using data from a secondary healthcare center in the city. We determine an increasing trend in stroke admissions since 2020, with a notable 22.4% increase in 2023, mainly due to ischemic stroke occurrence. In the same year, a significant non-linear relationship between stroke incidence and frequency of news about attacks was observed. Ordinal regression analysis of general sociodemographic, clinical, and healthcare-related factors influencing outcomes for intravenous thrombolysis-treated patients, revealed the significance of the 24-h National Institutes of Health Stroke Scale score (0.32 ± 0.03) and interaction of age and Door-to-Needle Time (- 0.28 ± 0.08). However, the extension of the latter independently is not significantly correlated with patient outcomes. In conclusion, war-induced stress, intranational migrations, and lack of adequate chronic cardiovascular disease management are primarily responsible for these results. Modulations and improvements to the current healthcare system, including managing chronic diseases and early stroke symptom recognition, are necessary to optimize patient outcomes.

摘要

卒中是乌克兰广泛存在的健康问题,俄乌战争带来的负担加剧了其严重性和影响。本研究旨在通过城市二级医疗机构的数据,全面评估伊万诺-弗兰科夫斯克的整体卒中流行病学情况。我们发现,自 2020 年以来,卒中入院人数呈上升趋势,2023 年增加了 22.4%,主要是由于缺血性卒中的发生。同年,我们观察到卒中发病率与攻击新闻频率之间存在显著的非线性关系。对静脉溶栓治疗患者的一般社会人口学、临床和医疗相关因素影响结局的有序回归分析表明,24 小时国立卫生研究院卒中量表评分(0.32±0.03)和年龄与Door-to-Needle Time 的交互作用具有显著意义(-0.28±0.08)。然而,后者的延长与患者结局没有显著相关性。总之,战争引发的压力、国内移民以及慢性心血管疾病管理不足是造成这些结果的主要原因。需要对当前的医疗保健系统进行调整和改进,包括管理慢性疾病和早期识别卒中症状,以优化患者结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89fc/11329696/4c86e0d2ff9c/41598_2024_70270_Fig1_HTML.jpg

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