Analysis of Patients in the Emergency Department With a Diagnosis of Cerebrovascular Disease During the COVID-19 Pandemic

Öz

Cerebrovascular disease remains one of the most common serious neurological conditions in adults today. Acute cerebrovascular disease, whether ischemic or hemorrhagic, requires rapid diagnosis and treatment due to its time-sensitive and dynamic course. To improve the prognosis of acute ischemic stroke patients, appropriate treatment methods such as cardiovascular and metabolic stabilization, emergency thrombolysis, anticoagulant and antiplatelet therapies, or mechanical thrombectomy should be initiated in emergency departments. This study aimed to retrospectively examine the effects of the COVID-19 pandemic process on patients who applied to the emergency department with a diagnosis of cerebrovascular disease.A total of 543 patients who applied to the emergency department were examined retrospectively and cross-sectionally, and 352 patients who applied in the pre-pandemic period (April 1, 2019 - March 1, 2020) and 191 patients who applied during the pandemic period (April 1, 2020 - March 1, 2021) were included in the study.When the complaints of patients who came to the emergency department before and after the pandemic were compared, there was a statistically significant difference in terms of complaints of syncope (p = 0.024) and general condition disorder (p = 0.030), but no significant difference was found in terms of other complaints. Patients who came to the emergency department with complaints of syncope after the pandemic (% 12.5) was found to be higher than the previous period (6.82%). While the rate of hemorrhagic CVD history in the pre-pandemic period was found to be higher at 2.8% than in the post-pandemic period (0%), the rate of those without a CVH history (84.3%) was found to be higher in the post-pandemic period.The COVID-19 pandemic has once again demonstrated the contribution of retrospective studies and case reports to the literature. As the samples of this study increase, the data obtained will become stronger and will shed light on whether COVID-19 disease, which affects a large number of people in all age groups around the world, is a risk factor for cerebrovascular disease.

Anahtar Kelimeler

• emergency department
• COVID-19
• cerebrovascular disease

COVID-19 Pandemi Sürecinde Serebrovasküler Hastalık Tanısı ile Acil Servise Başvuran Hastaların Analizi

Öz

Serebrovasküler hastalık günümüzde yetişkinlerde yaygın ciddi nörolojik durumlardan birisi olmaya devam etmektedir. Akut serebrovasküler hastalık, ister iskemik ister hemorajik olsun, zamana duyarlı ve dinamik seyirli olması nedeniyle hızlı tanı ve tedavi gerektirmektedir. Akut iskemik inme hastalarının prognozunu iyileştirmek için acil servislerde kardiyovasküler ve metabolik stabilizasyon, acil tromboliz, antikoagülan ve antiagregan tedaviler veya mekanik trombektomi gibi uygun tedavi yöntemleri başlanmalıdır. Bu çalışmada COVID-19 pandemi sürecinin acil servise serebrovasküler hastalık tanısıyla başvuran hastalara etkilerinin retrospektif olarak incelenmesi amaçlanmıştır. Acil servise başvuran toplam 543 hasta retrospektif kesitsel olarak incelenerek, pandemi öncesi dönemde (1 Nisan 2019- 1 Mart 2020) başvuran 352 hasta ve pandemi dönemi (1 Nisan 2020- 1 Mart 2021) başvuran 191 hasta çalışmaya dahil edilmiştir.Pandemi öncesi ve sonrası dönemde acile gelen hastaların şikâyet dağılımları karşılaştırıldığında senkop (p=0,024) ve genel durum bozukluğu (p=0,030) şikayetleri açısından istatistiksel olarak anlamlı farklılık bulunurken diğer şikayetler açısından anlamlı farklılık bulunmamıştır. Acile senkop şikâyeti ile gelen hastaların pandemi sonrasında (%12,5) öncesi döneme (%6,82) göre daha yüksek olduğu görülmüştür. Pandemi öncesi dönemdeki hemorajik SVH öykü oranı %2,8 ile pandemi sonrası döneme göre (%0) daha yüksek bulunurken SVH öyküsü olmayanların oranı (%84,3) pandemi sonrası dönemde daha yüksek bulunmuştur. COVID-19 pandemisi retrospektif çalışmaların ve vaka sunumlarının literatüre katkısını bir kez daha göstermiştir. Bu çalışmanın örneklerinin artmasıyla birlikte elde edilen veriler daha da güçlenecek, dünya genelinde fazla sayıda ve her yaş grubundan insanı etkileyen COVID-19 hastalığının serebrovasküler hastalık için bir risk faktörü olup olmadığına ışık tutacaktır.

Anahtar Kelimeler

• acil servis
• COVID-19
• serebrovasküler hastalık

Teşekkür

Bu makalede yer alan çalışmalarımıza katkılarından dolayı zamansız bir şekilde aramızdan ayrılan hocamız Prof. Dr.Erol ARMAĞAN’a teşekkür ederiz.

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