Decline in Stroke Presentations During COVID-19 Surge
Decline in Stroke Presentations During COVID-19 Surge
复制标题
DOI：
10.1161/strokeaha.120.030331
复制
发表时间：
2020-08-01
期刊：
影响因子：
8.3
通讯作者：
Hussain, M. Shazam
中科院分区：
文献类型：
--
作者：
Uchino, Ken;Kolikonda, Murali K.;Hussain, M. Shazam
背景和目的：我们旨在调查2019冠状病毒病（COVID-19）大流行期间的急性卒中表现。方法：数据来自美国东北部俄亥俄州一个有19个急诊部门的卫生系统。2020年1月1日至3月8日的基线期与2020年3月9日至4月2日的COVID期间进行比较。纳入的变量包括医院急诊科每日卒中警报总数、溶栓、就诊时间、卒中严重程度、从入院到成像的时间、从入院到溶栓穿刺的时间和从入院到血栓切除穿刺的时间。使用非参数统计和Poisson回归比较2个时间段。结果：902中风警报期间跨急诊科进行了分析。每日卒中警报总数从基线期间的中位数10（四分位数间距，8-13）降至COVID期间的中位数8（四分位数间距，4-10，P=0.001）。至就诊时间、卒中严重程度和至治疗时间不变。COVID期间与卒中警报减少相关，率比为0.70（95%CI，0.60-0.28）。溶栓治疗率比也下降，为0.52（95%CI，0.28-0.97），但血栓切除术率比保持不变，为0.93（95%CI，0.52-1.62）。结论：我们观察到，在COVID-19病例激增时，急诊科的急性卒中表现显著下降约30%。这一观察结果可能归因于中风发病率的真正下降或患者在大流行期间没有寻求紧急医疗护理。
Background and Purpose: We aimed to investigate the acute stroke presentations during the coronavirus disease 2019 (COVID-19) pandemic. Methods: The data were obtained from a health system with 19 emergency departments in northeast Ohio in the United States. Baseline period from January 1 to March 8, 2020, was compared with the COVID period from March 9, to April 2, 2020. The variables included were total daily stroke alerts across the hospital emergency departments, thrombolysis, time to presentation, stroke severity, time from door-to-imaging, time from door-to-needle in thrombolysis, and time from door-to-puncture in thrombectomy. The 2 time periods were compared using nonparametric statistics and Poisson regression. Results: Nine hundred two stroke alerts during the period across the emergency departments were analyzed. Total daily stroke alerts decreased from median, 10 (interquartile range, 8-13) during baseline period to median, 8 (interquartile range, 4-10,P=0.001) during COVID period. Time to presentation, stroke severity, and time to treatment were unchanged. COVID period was associated with decrease in stroke alerts with rate ratio of 0.70 (95% CI, 0.60-0.28). Thrombolysis also decreased with rate ratio, 0.52 (95% CI, 0.28-0.97) but thrombectomy remained unchanged rate ratio, 0.93 (95% CI, 0.52-1.62) Conclusions: We observed a significant decrease in acute stroke presentations by approximate to 30% across emergency departments at the time of surge of COVID-19 cases. This observation could be attributed to true decline in stroke incidence or patients not seeking medical attention for emergencies during the pandemic.