Collateral damage - Impact of a pandemic on stroke emergency services
Collateral damage - Impact of a pandemic on stroke emergency services
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DOI：
10.1016/j.jstrokecerebrovasdis.2020.104988
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发表时间：
2020-08-01
影响因子：
2.5
通讯作者：
Jadhav, Ashutosh P.
中科院分区：
文献类型：
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作者：
Desai, Shashvat M.;Guyette, Francis X.;Jadhav, Ashutosh P.
背景：COVID-19大流行对中风护理的影响是双重的-感染的直接影响和对非COVID-19疾病的间接影响。传闻证据和临床观察表明，在大流行期间，出现中风的患者人数有所减少。我们旨在了解COVID-19大流行对单一综合性卒中中心（CSC）卒中急救服务利用率的影响。研究方法：我们对前瞻性维护的数据库进行了回顾性分析，并将2017年3月至2019年3月收治的所有急诊科（艾德）就诊、急性卒中入院（包括TIA）和血栓切除术病例与2020年3月在综合性卒中中心收治的患者进行了比较。结果如下：与2020年3月相比，2017年3月至2019年3月期间总艾德发生率（22%，p = 0.005）、急性缺血性卒中（40%，p =0.001）和TIA（60%，p=0.163）下降。2020年3月接受EVT的患者数量与2017年3月至2019年3月相当（p=0.430）。结论：流行病相关的居家政策降低了CSC卒中急救服务的利用率。这种影响似乎在艾德、所有卒中入院和TIA中更为突出，而对重度卒中的影响较小。鉴于本地区COVID-19病例的患病率相对较低，这种减少可能与寻求医疗保健的行为有关，而不是能力饱和。
Background: The COVID-19 pandemic's impact on stroke care is two-fold - direct impact of the infection and indirect impact on non-COVID-19 diseases. Anecdotal evidence and clinical observation suggest that there is a decrease in the number of patients presenting with stroke during the pandemic. We aim to understand the impact of the COVID-19 pandemic on the utilization of stroke emergency services on a single comprehensive stroke center (CSC). Methods: We performed a retrospective analysis of a prospectively maintained database and compared all emergency department (ED) encounters, acute stroke admissions (including TIA), and thrombectomy cases admitted in March 2017-2019 to patients admitted in March 2020 at a comprehensive stroke center. Results: Number of total ED encounters (22%, p=0.005), acute ischemic strokes (40%, p=0.001), and TIAs (60%, p=0.163) decreased between March of 2017-2019 compared to March of 2020. The number of patients undergoing EVT in March 2020 was comparable to March 2017-2019 (p=0.430). Conclusion: A pandemic-related stay-at-home policy reduces the utilization of stroke emergency services at a CSC. This effect appears to be more prominent for ED encounters, all stroke admissions and TIAs, and less impactful for severe strokes. Given the relatively low prevalence of COVID-19 cases in our region, this decrement is likely related to healthcare seeking behavior rather than capacity saturation.