Analysis of Nationwide Stroke Patient Care in Times of COVID-19 Pandemic in Germany
Analysis of Nationwide Stroke Patient Care in Times of COVID-19 Pandemic in Germany
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DOI：
10.1161/strokeaha.120.033160
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发表时间：
2021-02-01
期刊：
影响因子：
8.3
通讯作者：
Krogias, Christos
中科院分区：
文献类型：
--
作者：
Richter, Daniel;Eyding, Jens;Krogias, Christos
背景与目的：自2019冠状病毒病（COVID-19）大流行开始以来，许多国家都采取了严格的保持社交距离的卫生措施，以防止疾病的进一步传播。这可能导致患有急性疾病和时间依赖性治疗（如中风）的患者到医院就诊的次数减少。方法：我们使用行政数据库对所有主要诊断为急性缺血性脑卒中（AIS）、短暂性脑缺血发作或脑出血的住院患者进行了一项全国性队列研究。来自德国1463家医院的数据被纳入其中。我们比较了大流行（2020年3月16日至5月15日）和大流行前（2020年1月16日至3月15日）的病例数和治疗特征，并与2019年相应时间段进行了比较。结果：我们发现，与大流行前相比，大流行期间AIS住院（-17.4%）、短暂性脑缺血发作（-22.9%）和脑出血（-15.8%）患者的住院率大幅下降。AIS患者的IVT率具有可比性（大流行前vs大流行前：16.4% vs 16.6%， P=0.448），而机械取栓率在大流行期间显著更高（8.1% vs 7.7%， P=0.044）。在大流行期间，AIS患者的住院死亡率显著增加（8.1%对7.6%，P=0.006）。结论：除了绝对病例数大幅下降外，我们的数据表明，在大流行期间寻求急性护理的AIS患者在德国继续接受急性再通治疗。
Background and Purpose:Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, many countries have introduced strict hygiene measures of social distancing to prevent further spreading of the disease. This may have led to a decreased presentation to hospital of patients with acute medical conditions and time-dependent management, such as stroke.Methods:We conducted a nationwide cohort study using administrative database of all hospitalized patients with main diagnosis of acute ischemic stroke (AIS), transient ischemic attack, or intracerebral hemorrhage. Data from a total of 1463 hospitals in Germany were included. We compared case numbers and treatment characteristics of pandemic (March 16 to May 15, 2020) and prepandemic (January 16 to March 15, 2020) cases and also with corresponding time period in 2019.Results:We identified a strong decline for hospitalization of AIS (-17.4%), transient ischemic attack (-22.9%), and intracerebral hemorrhage (-15.8%) patients during the pandemic compared with prepandemic period. IVT rate in patients with AIS was comparable (prepandemic versus pandemic: 16.4% versus 16.6%, P=0.448), whereas mechanical thrombectomy rate was significantly higher during the pandemic (8.1% versus 7.7%, P=0.044). In-hospital mortality was significantly increased in patients with AIS during the pandemic period (8.1% versus 7.6%, P=0.006).Conclusions:Besides a massive decrease in absolute case numbers, our data suggest that patients with AIS who did seek acute care during the pandemic, continued to receive acute recanalization treatment in Germany.