COVID-19’un genç hastalarda iskemik inme nedenli acil başvurularına etkisi: Kesintili zaman serisi analizi

Yıl 2024, Cilt: 29 Sayı: 1, 69 - 75, 27.01.2024

Betül Sümbül Şekerci , Özge Pasin , Asli Yaman , Tuğçe Pasin , Abdüsselam Şekerci

https://doi.org/10.21673/anadoluklin.1358649

Öz

Amaç: Bu çalışma, Koronavirüs Hastalığı-19 (COVID-19)’un Türkiye’deki bir üniversite hastanesinde hem genç hem de genel popülasyonda iskemik inme nedeniyle acil başvuru sıklığı üzerindeki etkisini değerlendirmeyi amaçlamaktadır.

Yöntemler: Bu çalışmada Bezmialem Vakıf Üniversitesi Hastanesi sisteminden retrospektif olarak toplanan veriler kullanılarak kesintili zaman serileri analizi kullanılmıştır. Çalışmaya Mayıs 2019 ile Şubat 2023 tarihleri arasında hastane acil servisine başvuran ve iskemik inme tanısı alan hastalar dahil edilmiştir.

Bulgular: Hastanemize iskemik inmeli 2196 hasta başvurmuş ve bunların 277’si genç inme hastası olduğu görülmüştür. Pandemi öncesi dönemde, iskemik inme nedeniyle hastane başvurularında istatiksel olarak anlamlı bir artış olmakla birlikte (p<0.001), genç inmeli olguların başvuru oranlarında anlamlı bir değişiklik gözlenmemiştir. (p>0,05). COVID-19 pandemisi acil iskemik inme başvuruları üzerinde ani bir etkiye neden olmuş ve toplam başvuru sayılarında önemli bir düşüşe yol açmıştır. COVID-19 sonrası dönem analiz edildiğinde, COVID-19’un genç popülasyondaki inme oranları üzerinde istatiksel açıdan anlamlı bir etkisi olmadığı görülmüştür.

Sonuç: İskemik inmeli hastaların hastaneye başvuruları, COVID-19 döneminde uygulanan karantina önlemlerinin sonuçlarından önemli ölçüde etkilenmiştir. Ancak kesintili zaman serisi analizi kullanılarak COVID-19 sonrası analizi edildiğinde, genç iskemik inmeli hastaların başvurularında COVID-19’un anlamlı bir etkisi gözlenmemiştir.

Anahtar Kelimeler

COVID-19, inme, veri analizi

Proje Numarası

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Effect of COVID-19 on emergency admissions for young patients with ischemic stroke: An interrupted time series analysis

Öz

Aim: This study aims to evaluate the influence of Coronavirus Disease-19 (COVID-19) on the frequency of emergency admissions for ischemic stroke among both young and general populations at a university hospital in Turkey.

Methods: An interrupted time series analysis was employed in this study, utilizing retrospectively collected data from the Bezmialem Vakıf University Hospital system. The study included patients who visited the hospital emergency department from May 2019 to February 2023 and were diagnosed with ischemic stroke.

Results: 2196 patients with ischemic stroke were admitted to our hospital and 277 of them were young stroke patients. During the pre-pandemic period, there was a noteworthy rise in overall admissions for ischemic stroke (p<0.001); however, no significant change was observed in the rate of admissions for young stroke cases (p>0.05). The COVID-19 pandemic had an immediate impact on emergency ischemic stroke admissions, leading to a significant decrease in total admission numbers. Upon analyzing the post-COVID-19 period, we observed that COVID-19 did not exert a significant influence on the rate of strokes among the youth population.

Conclusion: The hospital admissions of patients with ischemic stroke have been significantly affected by the outcomes of quarantine measures implemented during the COVID-19 period. However, when the analysis of the post-COVID-19 period was conducted using interrupted time series analysis, a significant impact of COVID-19 on the admissions of young patients with ischemic stroke was not observed.

Anahtar Kelimeler

COVID-19, interrupted time series analysis, stroke

Etik Beyan

The study was approved by the Ethics Committee of the Bezmialem Vakif University (Number: 95128).

Destekleyen Kurum

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Proje Numarası

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Teşekkür

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Kaynakça

• Azarpazhooh MR, Morovatdar N, Avan A, et al. COVID-19 Pandemic and Burden of Non-Communicable Diseases: An Ecological Study on Data of 185 Countries. J Stroke Cerebrovasc Dis. 2020;29(9):105089.
• Ellul MA, Benjamin L, Singh B, et al. Neurological associations of COVID-19. Lancet Neurol. 2020;19(9):767-83.
• Merkler AE, Parikh NS, Mir S, et al. Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza. JAMA Neurol. 2020;77(11):1-7.
• Yang X, Chen Y, Zhang W, et al. Association Between Inflammatory Biomarkers and Cognitive Dysfunction Analyzed by MRI in Diabetes Patients. Diabetes Metab Syndr Obes. 2020;13:4059-65.
• Modin D, Claggett B, Sindet-Pedersen C, et al. Acute COVID-19 and the Incidence of Ischemic Stroke and Acute Myocardial Infarction. Circulation. 2020;142(21):2080-2.
• Katsoularis I, Fonseca-Rodríguez O, Farrington P, Lindmark K, Fors Connolly AM. Risk of acute myocardial infarction and ischaemic stroke following COVID-19 in Sweden: a self-controlled case series and matched cohort study. Lancet. 2021;398(10300):599-607.
• Qureshi AI, Baskett WI, Huang W, et al. Acute Ischemic Stroke and COVID-19: An Analysis of 27 676 Patients. Stroke. 2021;52(3):905-12.
• Bekelis K, Missios S, et al. Ischemic Stroke Occurs Less Frequently in Patients With COVID-19: A Multicenter Cross-Sectional Study. Stroke. 2020;51(12):3570-6.
• Ekker MS, Boot EM, Singhal AB, et al. Epidemiology, aetiology, and management of ischaemic stroke in young adults. Lancet Neurol. 2018;17(9):790-801.
• Fifi JT, Mocco J. COVID-19 related stroke in young individuals. Lancet Neurol. 2020;19(9):713-5.
• Ghoreishi A, Arsang-Jang S, Sabaa-Ayoun Z, et al. Stroke Care Trends During COVID-19 Pandemic in Zanjan Province, Iran. From the CASCADE Initiative: Statistical Analysis Plan and Preliminary Results. J Stroke Cerebrovasc Dis. 2020;29(12):105321.
• Nagano H, Shin JH, Morishita T, et al. Hospitalization for ischemic stroke was affected more in independent cases than in dependent cases during the COVID-19 pandemic: An interrupted time series analysis. PLoS One. 2021;16(12):e0261587.
• 13. Tani T, Imai S, Fushimi K. Impact of the COVID-19 pandemic on emergency admission for patients with stroke: a time series study in Japan. Neurol Res Pract. 2021;3(1):64.
• Wang SY, Seghieri C, Vainieri M, Groene O. Changes in Acute Myocardial Infarction, Stroke, and Heart Failure Hospitalizations During COVID-19 Pandemic in Tuscany-An Interrupted Time Series Study. Int J Public Health. 2022;67:1604319.
• Pinto R, Valentim R, Fernandes da Silva L, et al. Use of Interrupted Time Series Analysis in Understanding the Course of the Congenital Syphilis Epidemic in Brazil. The Lancet Regional Health – Americas. 2022;7.
• Shadish WR, Cook TD. Experimental and quasi-experimental designs for generalized causal inference. Boston, MA, US: Houghton, Mifflin and Company; 2002. xxi, 623-xxi, p.
• Wagner AK, Soumerai SB, Zhang F, Ross-Degnan D. Segmented regression analysis of interrupted time series studies in medication use research. J Clin Pharm Ther. 2002;27(4):299-309.
• Bernal JL, Cummins S, Gasparrini A. Interrupted time series regression for the evaluation of public health interventions: a tutorial. Int J Epidemiol. 2017;46(1):348-55.
• Interrupted Time Series [updated 19/07/2023. Available from: https://ds4ps.org/pe4ps-textbook/docs/p-020-time-series.html. Erişim tarihi: 01.06.202
• English P. The its.analysis R Package – Modelling Short Time Series Data. (June 6, 2019). Available at SSRN: https://ssrn.com/abstract=3398189. Erişim tarihi: 01.06.2023
• Hathidara MY, Saini V, Malik AM. Stroke in the Young: a Global Update. Curr Neurol Neurosci Rep. 2019;19(11):91.
• Sarfo FS, Ovbiagele B, Gebregziabher M, et al. Stroke Among Young West Africans: Evidence From the SIREN (Stroke Investigative Research and Educational Network) Large Multisite Case-Control Study. Stroke. 2018;49(5):1116-22.
• Griffiths D, Sturm J. Epidemiology and etiology of young stroke. Stroke Res Treat. 2011;2011:209370.
• Marini C, Russo T, Felzani G. Incidence of stroke in young adults: a review. Stroke Res Treat. 2010;2011:535672.
• Béjot Y, Bailly H, Durier J, Giroud M. Epidemiology of stroke in Europe and trends for the 21st century. Presse Med. 2016;45(12 Pt 2):e391-e8.
• Gabet A, Grave C, Tuppin P, Chatignoux E, Béjot Y, Olié V. Impact of the COVID-19 pandemic and a national lockdown on hospitalizations for stroke and related 30-day mortality in France: A nationwide observational study. Eur J Neurol. 2021;28(10):3279-88.
• D’Anna L, Brown M, Oishi S, et al. Impact of National Lockdown on the Hyperacute Stroke Care and Rapid Transient Ischaemic Attack Outpatient Service in a Comprehensive Tertiary Stroke Centre During the COVID-19 Pandemic. Front Neurol. 2021;12:627493.
• Velilla-Alonso G, García-Pastor A, Rodríguez-López Á, et al. Acute Stroke Care during the COVID-19 Pandemic: Reduction in the Number of Admissions of Elderly Patients and Increase in Prehospital Delays. Cerebrovasc Dis. 2021;50(3):310-6.
• Nogueira RG, Abdalkader M, Qureshi MM, et al. Global impact of COVID-19 on stroke care. Int J Stroke. 2021;16(5):573-84.
• Moynihan R, Sanders S, Michaleff ZA, et al. Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review. BMJ Open. 2021;11(3):e045343.
• Mariet AS, Duloquin G, Benzenine E, et al. Impact of the First COVID-19 Wave on French Hospitalizations for Myocardial Infarction and Stroke: A Retrospective Cohort Study. Biomedicines. 2022;10(10):2501.
• Oxley TJ, 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(20):e60.