背景:2019年新型冠状病毒病(COVID-19)的爆发引起了人们对医疗保健系统为中风患者提供适当护理的能力的担忧。在本研究中,我们检查了COVID-19流行期间神户市中风护理的提供情况,一些主要的中风中心停止提供紧急护理。
方法:这是一项横断面研究。神户卒中网络调查了2020年3月1日至5月23日以及2019年3月3日至5月25日期间该市所有主要卒中中心(PSC)收治的卒中患者数量。此外,所有PSC董事之间的在线会议定期举行,以共享信息。调查项目包括应急响应系统特征,发病7天内住院的中风患者数量,给药治疗类型(IVrt-PA,机械血栓切除术,手术,和血管内治疗),和确诊为COVID-19的卒中患者。
结果:在2020年关注期间,13个PSC住院的卒中患者人数为813人,比2019年同期减少15.5%(p=0.285)。收治的脑梗塞患者数量,脑出血,蛛网膜下腔出血减少15.4%(p=0.245),16.1%(p=0.659),和14.0%(p=0.715),分别。然而,脑出血的机械取栓和手术率略有增加12.1%(p=0.754)和5.0%(p=0.538),分别。与2019年同期相比,停止提供急诊护理的PSC报告中风病例数减少了65.7%,而其他PSC报告增加了0.8%。在研究期间,没有报告一例中风和确诊的COVID-19患者。
结论:神户市能够维持其中风护理系统的运行,这要归功于所有城市PSC之间的密切合作以及中风病例总数的暂时减少。
BACKGROUND: The novel coronavirus disease 2019 (COVID-19) outbreak raised concerns over healthcare systems\' ability to provide suitable care to stroke patients. In the present study, we examined the provision of stroke care in Kobe City during the COVID-19 epidemic, where some major stroke centers ceased to provide emergency care.
METHODS: This was a cross-sectional study. The Kobe Stroke Network surveyed the number of stroke patients admitted to all primary stroke centers (PSCs) in the city between March 1 and May 23, 2020, and between March 3 and May 25, 2019. In addition, online meetings between all PSC directors were held regularly to share information. The survey items included emergency response system characteristics, number of patients with stroke hospitalized within 7 days of onset, administered treatment types (IV rt-PA, mechanical thrombectomy, surgery, and endovascular therapy), and stroke patients with confirmed COVID-19.
RESULTS: During the period of interest in 2020, the number of stroke patients hospitalized across 13 PSCs was 813, which was 15.5% lower than that during the same period of 2019 (p = 0.285). The number of patients admitted with cerebral infarction, intracerebral hemorrhage, and subarachnoid hemorrhage decreased by 15.4% (p = 0.245), 16.1% (p = 0.659), and 14.0% (p = 0.715), respectively. However, the rates of mechanical thrombectomy and surgery for intracerebral hemorrhage were slightly increased by 12.1% (p = 0.754) and 5.0% (p = 0.538), respectively. PSCs that ceased to provide emergency care reported a decrease in the number of stroke cases of 65.7% compared with the same period in 2019, while other PSCs reported an increase of 0.8%. No case of a patient with stroke and confirmed COVID-19 was reported during the study period.
CONCLUSIONS: Kobe City was able to maintain operation of its stroke care systems thanks to close cooperation among all city PSCs and a temporal decrease in the total number of stroke cases.