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Slump in Hospital Admissions for Stroke, a Fact of an Uncertain Nature That Requires Explanation

(1) Background: The impact of the health crisis caused by coronavirus disease 2019 (COVID-19) has provoked collateral effects in the attention to pathologies with time-dependent treatments such as strokes. We compare the healthcare activity of two stroke units in the same periods of 2019 and 2020, w...

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Autores principales: Ramírez-Moreno, José M., Portilla-Cuenca, Juan Carlos, Hariramani-Ramchandani, Roshan, Rebollo, Belen, Bermejo Casado, Inés, Macías-Sedas, Pablo, Ceberino, David, Roa-Montero, Ana M., González-Plata, Alberto, Casado, Ignacio, Fernández de Alarcón, Luis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828369/
https://www.ncbi.nlm.nih.gov/pubmed/33450843
http://dx.doi.org/10.3390/brainsci11010092
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author Ramírez-Moreno, José M.
Portilla-Cuenca, Juan Carlos
Hariramani-Ramchandani, Roshan
Rebollo, Belen
Bermejo Casado, Inés
Macías-Sedas, Pablo
Ceberino, David
Roa-Montero, Ana M.
González-Plata, Alberto
Casado, Ignacio
Fernández de Alarcón, Luis
author_facet Ramírez-Moreno, José M.
Portilla-Cuenca, Juan Carlos
Hariramani-Ramchandani, Roshan
Rebollo, Belen
Bermejo Casado, Inés
Macías-Sedas, Pablo
Ceberino, David
Roa-Montero, Ana M.
González-Plata, Alberto
Casado, Ignacio
Fernández de Alarcón, Luis
author_sort Ramírez-Moreno, José M.
collection PubMed
description (1) Background: The impact of the health crisis caused by coronavirus disease 2019 (COVID-19) has provoked collateral effects in the attention to pathologies with time-dependent treatments such as strokes. We compare the healthcare activity of two stroke units in the same periods of 2019 and 2020, with an emphasis on what happened during the state of alarm (SA). (2) Materials and methods. Hospitals in the region implemented contingency plans to contain the pandemic; in this planning, the stroke units were not limited in their operational capacity. The SA was declared on 15 March and remained in place for 10 weeks. For the analysis, the data were grouped by consecutive calendar weeks. (3) Results. When the SA was declared the number of calls to the emergency telephone went from 1225 to 3908 calls per week (318% increase). However, the activation of the stroke code went from 6.6 to 5.0 (p = 0.04) and the activity in both stroke units decreased. The largest drop in hospitalizations was for transient ischemic attacks (TIAs) with 35.7% less, 28 vs. 18, (p = 0.05). Reperfusion therapies fell by 37.5%; Poisson regression model 0.64; (95% confidence interval (CI), 0.43–0.95). The overall activity of the telestroke suffered a reduction of 28.9%. We also observed an increase in hospital mortality. (4) Conclusion. The excessive duration of the pandemic precludes any hope of resolving this public health crisis in the short or medium term. Further studies should be conducted to better understand the multifactorial nature of this dramatic decline in stroke admissions and its negative impact.
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spelling pubmed-78283692021-01-25 Slump in Hospital Admissions for Stroke, a Fact of an Uncertain Nature That Requires Explanation Ramírez-Moreno, José M. Portilla-Cuenca, Juan Carlos Hariramani-Ramchandani, Roshan Rebollo, Belen Bermejo Casado, Inés Macías-Sedas, Pablo Ceberino, David Roa-Montero, Ana M. González-Plata, Alberto Casado, Ignacio Fernández de Alarcón, Luis Brain Sci Article (1) Background: The impact of the health crisis caused by coronavirus disease 2019 (COVID-19) has provoked collateral effects in the attention to pathologies with time-dependent treatments such as strokes. We compare the healthcare activity of two stroke units in the same periods of 2019 and 2020, with an emphasis on what happened during the state of alarm (SA). (2) Materials and methods. Hospitals in the region implemented contingency plans to contain the pandemic; in this planning, the stroke units were not limited in their operational capacity. The SA was declared on 15 March and remained in place for 10 weeks. For the analysis, the data were grouped by consecutive calendar weeks. (3) Results. When the SA was declared the number of calls to the emergency telephone went from 1225 to 3908 calls per week (318% increase). However, the activation of the stroke code went from 6.6 to 5.0 (p = 0.04) and the activity in both stroke units decreased. The largest drop in hospitalizations was for transient ischemic attacks (TIAs) with 35.7% less, 28 vs. 18, (p = 0.05). Reperfusion therapies fell by 37.5%; Poisson regression model 0.64; (95% confidence interval (CI), 0.43–0.95). The overall activity of the telestroke suffered a reduction of 28.9%. We also observed an increase in hospital mortality. (4) Conclusion. The excessive duration of the pandemic precludes any hope of resolving this public health crisis in the short or medium term. Further studies should be conducted to better understand the multifactorial nature of this dramatic decline in stroke admissions and its negative impact. MDPI 2021-01-13 /pmc/articles/PMC7828369/ /pubmed/33450843 http://dx.doi.org/10.3390/brainsci11010092 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ramírez-Moreno, José M.
Portilla-Cuenca, Juan Carlos
Hariramani-Ramchandani, Roshan
Rebollo, Belen
Bermejo Casado, Inés
Macías-Sedas, Pablo
Ceberino, David
Roa-Montero, Ana M.
González-Plata, Alberto
Casado, Ignacio
Fernández de Alarcón, Luis
Slump in Hospital Admissions for Stroke, a Fact of an Uncertain Nature That Requires Explanation
title Slump in Hospital Admissions for Stroke, a Fact of an Uncertain Nature That Requires Explanation
title_full Slump in Hospital Admissions for Stroke, a Fact of an Uncertain Nature That Requires Explanation
title_fullStr Slump in Hospital Admissions for Stroke, a Fact of an Uncertain Nature That Requires Explanation
title_full_unstemmed Slump in Hospital Admissions for Stroke, a Fact of an Uncertain Nature That Requires Explanation
title_short Slump in Hospital Admissions for Stroke, a Fact of an Uncertain Nature That Requires Explanation
title_sort slump in hospital admissions for stroke, a fact of an uncertain nature that requires explanation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828369/
https://www.ncbi.nlm.nih.gov/pubmed/33450843
http://dx.doi.org/10.3390/brainsci11010092
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