Care Process of Recanalization Therapy for Acute Stroke during the COVID-19 Outbreak in South Korea.
Care Process of Recanalization Therapy for Acute Stroke during the COVID-19 Outbreak in South Korea.
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DOI：
10.3988/jcn.2021.17.1.63
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
SMART-EST Study Group
中科院分区：
文献类型：
--
作者：
Kim YD;Nam HS;Sohn SI;Park H;Hong JH;Kim GS;Seo KD;Yoo J;Baek JH;Seo JH;Heo J;Baik M;Lee HS;Heo JH;SMART-EST Study Group
我们的目的是确定在韩国2019冠状病毒病（COVID-19）爆发期间，接受再通治疗的急性卒中患者的护理过程和结果是否发生了变化。我们使用来自前瞻性多中心再灌注治疗登记的数据来比较韩国COVID-19爆发之前和期间的护理过程（包括从症状出现到治疗的时间、接受治疗的患者数量和出院情况）和治疗结果。韩国新冠肺炎疫情爆发后，接受血管内治疗的患者虽然暂时减少，但数量明显减少。卒中患者使用紧急医疗服务的比例从COVID-19爆发前的91.5%增加到COVID-19爆发期间的100.0% (p=0.025)，从症状出现到就诊的中位数时间也增加了[中位数（四分位数间距），91.0分钟（39.8-277.0）对176.0分钟（56.0-391.5），p=0.029]。此外，更多的功能依赖的残疾患者出院回家（59.5%比26.1%,p=0.020），而不是留在地区或康复医院。相比之下，从入院到脑成像和治疗的时间、功能结局、再通成功率、症状性脑出血发生率均无与covid -19相关的变化。这些发现表明，在2019冠状病毒病爆发期间，院前延误发生了，急性中风患者可能不愿意去医院就诊和住院。我们的研究结果提示，在2019冠状病毒病暴发期间，应重视急性脑卒中患者的院前护理和行为。
We aimed to determine whether the care process and outcomes in patients with acute stroke who received recanalization therapy changed during the outbreak of coronavirus disease 2019 (COVID-19) in South Korea. We used data from a prospective multicenter reperfusion therapy registry to compare the care process—including the time from symptom onset to treatment, number of treated patients, and discharge disposition—and treatment outcomes between before and during the COVID-19 outbreak in South Korea. Upon the COVID-19 outbreak in South Korea, the number of patients receiving endovascular treatment to decrease temporarily but considerably. The use of emergency medical services by stroke patients increased from 91.5% before to 100.0% during the COVID-19 outbreak (p=0.025), as did the median time from symptom onset to hospital visit [median (interquartile range), 91.0 minutes (39.8–277.0) vs. 176.0 minutes (56.0–391.5), p=0.029]. Furthermore, more functionally dependent patients with disabilities were discharged home (59.5% vs. 26.1%, p=0.020) rather than staying in a regional or rehabilitation hospital. In contrast, there were no COVID-19-related changes in the times from the hospital visit to brain imaging and treatment or in the functional outcome, successful recanalization rate, or rate of symptomatic intracerebral hemorrhage. These findings suggest that a prehospital delay occurred during the COVID-19 outbreak, and that patients with acute stroke might have been reluctant to visit and stay in hospitals. Our findings indicate that attention should be paid to prehospital care and the behavior of patients with acute stroke during the COVID-19 outbreak.
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