Yıl: 2021 Cilt: 27 Sayı: 2 Sayfa Aralığı: 171 - 175 Metin Dili: İngilizce DOI: 10.4274/tnd.2021.50133 İndeks Tarihi: 19-01-2022

Decreased Stroke Applications During Pandemic: Collateral Effects of COVID-19

Öz:
Objective: Our study aimed to investigate the effects of the pandemic on human behavior and stroke management by comparing hospital admissions made due to stroke during the pandemic period with the same period of the previous year. Materials and Methods: This retrospective study was conducted on patients with stroke admitted to our hospital between April 1st, 2020, and May 31st, 2020, and April 1st, 2019, and May 31st, 2019. Strokes were divided into three subgroups: ischemic stroke, hemorrhagic stroke, and transient ischemic attack (TIA). The total number of strokes, stroke subtypes, vascular risk factors, sociodemographic and clinical characteristics, National Institutes of Health Stroke Scale (NIHSS) scores, presence of large vessel occlusion, thrombolytic therapy use, intensive care unit requirement, and in-hospital mortality values were compared for both periods. Results: A total of 133 patients, 75 males, 58 females, 44 during the pandemic period and 89 in the previous year, were included in the study. The mean age of the patients was 71.29±13.12 years. During the pandemic period, compared with the same period one year ago, there was a 50% decrease in the number of strokes, a 44% decrease in the number of ischemic strokes, a 62.5% decrease in the number of intracranial hemorrhages, and an 87.5% decrease in the number of TIA. During the pandemic period, the rate of patients who received intravenous thrombolytic therapy, the rate of patients with large vessel occlusion, the inhospital mortality rate, and the mean NIHSS scores were found to be significantly higher during the pandemic, but the rate of patients who had a minor stroke was significantly lower. Conclusion: The pandemic period has brought along many unknowns. It is a matter of curiosity how the effects of the pandemic on human behavior and functioning in health institutions will affect the diagnosis, treatment, and long-term follow-up of diseases other than coronavirus disease-2019.
Anahtar Kelime:

Pandemi Döneminde Azalmış İnme Başvuruları: COVID-19’un Kollateral Etkileri

Öz:
Amaç: Çalışmamız, pandemi döneminde inme sebebiyle yapılan hastane başvurularını bir önceki yılın aynı dönemiyle kıyaslayarak pandeminin insan davranışları ve inme yönetimine olan etkilerini araştırmayı amaçlamaktadır. Gereç ve Yöntem: Bu retrospektif çalışma, hastenemize 1 Nisan 2020 ve 31 Mayıs 2020 ile 1 Nisan 2019 ve 31 Mayıs 2019 tarihleri arasında kabul edilen inme geçiren hastalar üzerinde gerçekleştirildi. Hastalar inme tipine göre; iskemik inme, hemorajik inme ve geçici iskemik atak (GİA) olmak üzere üç alt gruba ayrıldı. Her iki döneme ait toplam inme sayıları, inme alt tipleri, vasküler risk faktörleri, sosyodemografik ve klinik özellikler, Ulusal Sağlık İnme Enstitüsü Ölçeği (NIHSS) değerleri, büyük damar oklüzyonu varlığı, trombolitik tedavi kullanımı, yoğun bakım yatış gereksinimi ve hastane içi mortalite değerleri birbiriyle kıyaslandı. Bulgular: Çalışmaya yaş ortalaması 71,29±13,12 olan 75 erkek, 58 kadın; pandemi döneminde 44, bir yıl önceki dönemde 89 olmak üzere toplamda 133 hasta alınmıştır. Pandemi döneminde bir yıl önceki aynı dönemle karşılaştırıldığında, hastaneye kabullerde tüm inme geçiren hasta sayılarında yüzde 50, iskemik inme sayılarında %44, intrakraniyal hemoraji sayılarında %62,5, GİA sayılarında %87,5 düşüş saptandı. Pandemi döneminde tedavisinde intravenöz trombolitik tedavi kullanılan hasta oranı, büyük damar oklüzyonu saptanan hasta oranı, hastane içi mortalite oranı ve ortalama NIHSS skorları pandemi döneminde anlamlı derecede daha yüksek saptanırken, minör inme geçiren hasta oranı anlamlı derecede düşük saptandı. Sonuç: Pandemi dönemi birçok bilinmezi beraberinde getirmiştir. Pandeminin insan davranışları ve sağlık kuruluşlarındaki işleyişe olan etkilerinin koronavirüs hastalığı-2019 dışındaki hastalıkların tanı, tedavi ve uzun dönem takiplerini nasıl etkileyeceği merak konusudur.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Zhu N, Zhang D, Wang W et al. A novel corona virus from patients with pneumonia in China. N Engl J Med 2020;382:727-733.
  • 2. Masroor S. Collateral damage of COVID-19 pandemic: delayed medical care. J Card Surg 2020;35:1345-1347.
  • 3. Kablan Y. İnme: epidemiyoloji ve risk faktörleri. Turkiye Klinikleri J Neurol Special 2018;11:1-19.
  • 4. Broderick JP, Phillips SJ, O’Fallon WM, Frye RL, Whisnant JP. Relationship of cardiac diseases to stroke occurrence, recurrence and mortality. Stroke 1992;23:1250-1256.
  • 5. Morelli N, Rota E, Terracciano C, et al. The baffling case of ischemic stroke disappearance from the casualty department in the COVID-19 era. Eur Neurol 2020;83:213-215.
  • 6. Thornton J. Stroke: “striking reductions” are seen in number of people with symptoms seeking help. BMJ 2020;369:1406.
  • 7. Metzler B, Siostrzonek P, Binder RK, Bauer A, Reinstadler SJ. Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage. Eur Heart J 2020;41:1852-1853.
  • 8. Kansagra AP, Goyal MS, Hamilton S, Albers GW. Collateral effect of covid-19 on stroke evaluation in the United States. N Engl J Med 2020;383:400-401.
  • 9. Diegoli H, Magalhães PSC, Martins SCO, et al. Decrease in hospital admissions for transient ischemic attack, mild, and moderate stroke during the COVID-19 Era. Stroke 2020;51:2315-2321.
  • 10. Naccaratoa M, Scalia I, Olivoa S, et al. Has COVID-19 played an unexpected “stroke” on the chain of survival? J Neurol Sci 2020;414:116889.
  • 11. Siegler JE, Heslin ME, Thau L, Smith A, Jovin TG. Falling stroke rates during COVID-19 pandemic at a comprehensive stroke center. J Stroke Cerebrovasc Dis 2020;8:104953.
  • 12. Pan Y, Elm JJ, Li HM, et al. Outcomes associated with clopidogrel-aspirin use in minor stroke or transient ischemic attack: a pooled analysis of clopidogrel in high-risk patients with acute nondisabling cerebrovascular events (chance) and plateletoriented inhibition in new tia and minor ischemic stroke (point) trials. JAMA Neurol 2019;76:1466-1473.
  • 13. Coull AJ, Lovett JK, Rothwell PM; Oxford Vascular Study. Population based study of early risk of stroke after transient ischaemic attack or minor stroke: implications for public education and organisation of services. BMJ 2004;328:326.
  • 14. Rothwell PM, Giles MF, Chandratheva A, et al; Early Use of Existing Preventive Strategies for Stroke (EXPRESS) Study. Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison. Lancet 2007;370:1432-1442.
  • 15. Topcuoglu MA, Arsava EM, Ozdemir AO, Uzuner N. Stroke unit: general principles and standarts. Turk J Cerebrovasc Dis 2015;21:4-22.
  • 16. Mao L, Jin H, Wang, M et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol 2020;77:683-690.
  • 17. Oxley T J, Mocco J, Majidi S, et al. Large-vessel stroke as a presenting feature of covid-19 in the young. N Engl J Med 2020;382:e60.
APA ALTUNISIK E, arık a (2021). Decreased Stroke Applications During Pandemic: Collateral Effects of COVID-19. , 171 - 175. 10.4274/tnd.2021.50133
Chicago ALTUNISIK ERMAN,arık ali Decreased Stroke Applications During Pandemic: Collateral Effects of COVID-19. (2021): 171 - 175. 10.4274/tnd.2021.50133
MLA ALTUNISIK ERMAN,arık ali Decreased Stroke Applications During Pandemic: Collateral Effects of COVID-19. , 2021, ss.171 - 175. 10.4274/tnd.2021.50133
AMA ALTUNISIK E,arık a Decreased Stroke Applications During Pandemic: Collateral Effects of COVID-19. . 2021; 171 - 175. 10.4274/tnd.2021.50133
Vancouver ALTUNISIK E,arık a Decreased Stroke Applications During Pandemic: Collateral Effects of COVID-19. . 2021; 171 - 175. 10.4274/tnd.2021.50133
IEEE ALTUNISIK E,arık a "Decreased Stroke Applications During Pandemic: Collateral Effects of COVID-19." , ss.171 - 175, 2021. 10.4274/tnd.2021.50133
ISNAD ALTUNISIK, ERMAN - arık, ali. "Decreased Stroke Applications During Pandemic: Collateral Effects of COVID-19". (2021), 171-175. https://doi.org/10.4274/tnd.2021.50133
APA ALTUNISIK E, arık a (2021). Decreased Stroke Applications During Pandemic: Collateral Effects of COVID-19. Türk Nöroloji Dergisi, 27(2), 171 - 175. 10.4274/tnd.2021.50133
Chicago ALTUNISIK ERMAN,arık ali Decreased Stroke Applications During Pandemic: Collateral Effects of COVID-19. Türk Nöroloji Dergisi 27, no.2 (2021): 171 - 175. 10.4274/tnd.2021.50133
MLA ALTUNISIK ERMAN,arık ali Decreased Stroke Applications During Pandemic: Collateral Effects of COVID-19. Türk Nöroloji Dergisi, vol.27, no.2, 2021, ss.171 - 175. 10.4274/tnd.2021.50133
AMA ALTUNISIK E,arık a Decreased Stroke Applications During Pandemic: Collateral Effects of COVID-19. Türk Nöroloji Dergisi. 2021; 27(2): 171 - 175. 10.4274/tnd.2021.50133
Vancouver ALTUNISIK E,arık a Decreased Stroke Applications During Pandemic: Collateral Effects of COVID-19. Türk Nöroloji Dergisi. 2021; 27(2): 171 - 175. 10.4274/tnd.2021.50133
IEEE ALTUNISIK E,arık a "Decreased Stroke Applications During Pandemic: Collateral Effects of COVID-19." Türk Nöroloji Dergisi, 27, ss.171 - 175, 2021. 10.4274/tnd.2021.50133
ISNAD ALTUNISIK, ERMAN - arık, ali. "Decreased Stroke Applications During Pandemic: Collateral Effects of COVID-19". Türk Nöroloji Dergisi 27/2 (2021), 171-175. https://doi.org/10.4274/tnd.2021.50133