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

Yıl 2024, Cilt: 50 Sayı: 2, 257 - 261, 08.10.2024
https://doi.org/10.32708/uutfd.1513408

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.

Teşekkür

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

Kaynakça

  • 1. Stone CK, Humphries R. Neurologic Emergencies, in Current Diagnosis & Treatment. 2017. p. 636-67.
  • 2. Grotta JC, Albers GW, Broderick JP, et al. The Neurovascular Unit and Responses to Ischemia, in Stroke: Pathophysiology, Diagnosis, and Management 2021. p. 82-91.
  • 3. Andersen SD, Gorst-Rasmussen A, Bach FW, et al. Recurrent stroke: the value of the CHA2DS2VASc score and the essen stroke risk score in a nationwide stroke cohort. 2015. 46. 2491-7.
  • 4. Zhong W, Geng N, Wang P, et al. Prevalence, causes and risk factors of hospital readmissions after acute stroke and transient ischemic attack: a systematic review and meta-analysis. 2016. 37(8):1195-202.
  • 5. Rabinstein AA. Update on Treatment of Acute Ischemic Stroke. 2020. 26(2):268-286.
  • 6. Amin HP, Madsen TE, Bravata DM., et al. American Heart Association Emergency Neurovascular Care Committee of the Stroke Council and Council on Peripheral Vascular Disease. Diagnosis, Workup, Risk Reduction of Transient Ischemic Attack in the Emergency Department Setting: A Scientific Statement From the American Heart Association. 2023. 54(3): 109-21.
  • 7. Montaño A, Hanley DF, Hemphill JC 3rd. Hemorrhagic stroke. Handb Clin Neurol. 2021;176: 229-48.
  • 8. Beghi E, Giussani G, Westenberg E, et al. Acute and post-acute neurological manifestations of COVID-19: present findings, critical appraisal, and future directions. Journal of neurology, 2021; 1-10.
  • 9. Abbasi-Oshaghi E, Mirzaei F, Farahani F, Khodadadi I, Tayebinia H. Diagnosis and treatment of coronavirus disease 2019 (COVID-19): Laboratory, PCR, and chest CT imaging findings. International Journal of Surgery, 2020; 79: 143-53.
  • 10. Conway EM, Mackman N, Warren RQ., et al. Understanding COVID-19-associated coagulopathy. 2022. ;22(10):639-49.
  • 11. Catherine C, Veitinger J, Chou SH. COVID-19 and Cerebrovascular Disease. 2023; 43(2): 219-28.
  • 12. Vural A, Aksoy İ, Ekiz M. The Change in Acute Ischemic Stroke Numbers in the Emergency Service During Early Phase of COVID -19 Pandemic. 2022. 8(1):139-45.
  • 13. Slagman A, Behringer W, Greiner F, et al. German Forum of University Emergency Departments (FUN) in the Society of University Clinics of Germany E.V.. Medical Emergencies During the COVID-19 Pandemic. 2020. 17;117. 545-52.
  • 14. Dhamoon MS, Thaler A, Gururangan K,et al. Acute Cerebrovascular Events With COVID-19 Infection. 2021;52(1):48-56.
  • 15. Lange S. Goodman A., Dias T., Twentyman E., et al. Potential in-direct effects of the COVID-19 pandemic on use of emergency departments for acutelife-threatening conditions-United States. 2020;69(25):795–800.
  • 16. Park B, Bae W, Kim HJ, et al. Impact of COVID-19 pandemic on patients with cardio/cerebrovascular disease who visit the emergency department. 2022;58:100-5.
  • 17. Luo W, Liu X, Bao K. Ischemic stroke associated with COVID-19: a systematic review and meta-analysis. 2022;269(4):1731-40.
  • 18. Ko JY, Danielson ML, Town M., et al. Risk Factors for Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization: COVID-19-Associated Hospitalization Surveillance Network and Behavioral Risk Factor Surveillance System. 2021. 1;72(11): 695-703.
  • 19. Nannoni S, Groot R, Bell S. Stroke in COVID-19: A systematic review and meta-analysis. 2021;16(2):137-149.
  • 20. Florez WA, Serrato SA, Bosque P., et al. Relationship between the history of cerebrovascular disease and mortality in COVID-19 patients: A systematic review and meta-analysis. 2020; 197:106183.

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

Yıl 2024, Cilt: 50 Sayı: 2, 257 - 261, 08.10.2024
https://doi.org/10.32708/uutfd.1513408

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.

Kaynakça

  • 1. Stone CK, Humphries R. Neurologic Emergencies, in Current Diagnosis & Treatment. 2017. p. 636-67.
  • 2. Grotta JC, Albers GW, Broderick JP, et al. The Neurovascular Unit and Responses to Ischemia, in Stroke: Pathophysiology, Diagnosis, and Management 2021. p. 82-91.
  • 3. Andersen SD, Gorst-Rasmussen A, Bach FW, et al. Recurrent stroke: the value of the CHA2DS2VASc score and the essen stroke risk score in a nationwide stroke cohort. 2015. 46. 2491-7.
  • 4. Zhong W, Geng N, Wang P, et al. Prevalence, causes and risk factors of hospital readmissions after acute stroke and transient ischemic attack: a systematic review and meta-analysis. 2016. 37(8):1195-202.
  • 5. Rabinstein AA. Update on Treatment of Acute Ischemic Stroke. 2020. 26(2):268-286.
  • 6. Amin HP, Madsen TE, Bravata DM., et al. American Heart Association Emergency Neurovascular Care Committee of the Stroke Council and Council on Peripheral Vascular Disease. Diagnosis, Workup, Risk Reduction of Transient Ischemic Attack in the Emergency Department Setting: A Scientific Statement From the American Heart Association. 2023. 54(3): 109-21.
  • 7. Montaño A, Hanley DF, Hemphill JC 3rd. Hemorrhagic stroke. Handb Clin Neurol. 2021;176: 229-48.
  • 8. Beghi E, Giussani G, Westenberg E, et al. Acute and post-acute neurological manifestations of COVID-19: present findings, critical appraisal, and future directions. Journal of neurology, 2021; 1-10.
  • 9. Abbasi-Oshaghi E, Mirzaei F, Farahani F, Khodadadi I, Tayebinia H. Diagnosis and treatment of coronavirus disease 2019 (COVID-19): Laboratory, PCR, and chest CT imaging findings. International Journal of Surgery, 2020; 79: 143-53.
  • 10. Conway EM, Mackman N, Warren RQ., et al. Understanding COVID-19-associated coagulopathy. 2022. ;22(10):639-49.
  • 11. Catherine C, Veitinger J, Chou SH. COVID-19 and Cerebrovascular Disease. 2023; 43(2): 219-28.
  • 12. Vural A, Aksoy İ, Ekiz M. The Change in Acute Ischemic Stroke Numbers in the Emergency Service During Early Phase of COVID -19 Pandemic. 2022. 8(1):139-45.
  • 13. Slagman A, Behringer W, Greiner F, et al. German Forum of University Emergency Departments (FUN) in the Society of University Clinics of Germany E.V.. Medical Emergencies During the COVID-19 Pandemic. 2020. 17;117. 545-52.
  • 14. Dhamoon MS, Thaler A, Gururangan K,et al. Acute Cerebrovascular Events With COVID-19 Infection. 2021;52(1):48-56.
  • 15. Lange S. Goodman A., Dias T., Twentyman E., et al. Potential in-direct effects of the COVID-19 pandemic on use of emergency departments for acutelife-threatening conditions-United States. 2020;69(25):795–800.
  • 16. Park B, Bae W, Kim HJ, et al. Impact of COVID-19 pandemic on patients with cardio/cerebrovascular disease who visit the emergency department. 2022;58:100-5.
  • 17. Luo W, Liu X, Bao K. Ischemic stroke associated with COVID-19: a systematic review and meta-analysis. 2022;269(4):1731-40.
  • 18. Ko JY, Danielson ML, Town M., et al. Risk Factors for Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization: COVID-19-Associated Hospitalization Surveillance Network and Behavioral Risk Factor Surveillance System. 2021. 1;72(11): 695-703.
  • 19. Nannoni S, Groot R, Bell S. Stroke in COVID-19: A systematic review and meta-analysis. 2021;16(2):137-149.
  • 20. Florez WA, Serrato SA, Bosque P., et al. Relationship between the history of cerebrovascular disease and mortality in COVID-19 patients: A systematic review and meta-analysis. 2020; 197:106183.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Acil Tıp
Bölüm Özgün Araştırma Makaleleri
Yazarlar

Duygu Karakaş Uslusoy 0000-0002-7245-1500

Vahide Aslıhan Durak 0000-0003-0836-7862

İbrahim Uslusoy 0000-0001-6466-3397

Göksel Aydoğan 0009-0006-2750-207X

Halil İbrahim Çıkrıklar 0000-0002-6253-3350

Yayımlanma Tarihi 8 Ekim 2024
Gönderilme Tarihi 11 Temmuz 2024
Kabul Tarihi 20 Ağustos 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 50 Sayı: 2

Kaynak Göster

APA Karakaş Uslusoy, D., Durak, V. A., Uslusoy, İ., Aydoğan, G., vd. (2024). COVID-19 Pandemi Sürecinde Serebrovasküler Hastalık Tanısı ile Acil Servise Başvuran Hastaların Analizi. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 50(2), 257-261. https://doi.org/10.32708/uutfd.1513408
AMA Karakaş Uslusoy D, Durak VA, Uslusoy İ, Aydoğan G, Çıkrıklar Hİ. COVID-19 Pandemi Sürecinde Serebrovasküler Hastalık Tanısı ile Acil Servise Başvuran Hastaların Analizi. Uludağ Tıp Derg. Ekim 2024;50(2):257-261. doi:10.32708/uutfd.1513408
Chicago Karakaş Uslusoy, Duygu, Vahide Aslıhan Durak, İbrahim Uslusoy, Göksel Aydoğan, ve Halil İbrahim Çıkrıklar. “COVID-19 Pandemi Sürecinde Serebrovasküler Hastalık Tanısı Ile Acil Servise Başvuran Hastaların Analizi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 50, sy. 2 (Ekim 2024): 257-61. https://doi.org/10.32708/uutfd.1513408.
EndNote Karakaş Uslusoy D, Durak VA, Uslusoy İ, Aydoğan G, Çıkrıklar Hİ (01 Ekim 2024) COVID-19 Pandemi Sürecinde Serebrovasküler Hastalık Tanısı ile Acil Servise Başvuran Hastaların Analizi. Uludağ Üniversitesi Tıp Fakültesi Dergisi 50 2 257–261.
IEEE D. Karakaş Uslusoy, V. A. Durak, İ. Uslusoy, G. Aydoğan, ve H. İ. Çıkrıklar, “COVID-19 Pandemi Sürecinde Serebrovasküler Hastalık Tanısı ile Acil Servise Başvuran Hastaların Analizi”, Uludağ Tıp Derg, c. 50, sy. 2, ss. 257–261, 2024, doi: 10.32708/uutfd.1513408.
ISNAD Karakaş Uslusoy, Duygu vd. “COVID-19 Pandemi Sürecinde Serebrovasküler Hastalık Tanısı Ile Acil Servise Başvuran Hastaların Analizi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 50/2 (Ekim 2024), 257-261. https://doi.org/10.32708/uutfd.1513408.
JAMA Karakaş Uslusoy D, Durak VA, Uslusoy İ, Aydoğan G, Çıkrıklar Hİ. COVID-19 Pandemi Sürecinde Serebrovasküler Hastalık Tanısı ile Acil Servise Başvuran Hastaların Analizi. Uludağ Tıp Derg. 2024;50:257–261.
MLA Karakaş Uslusoy, Duygu vd. “COVID-19 Pandemi Sürecinde Serebrovasküler Hastalık Tanısı Ile Acil Servise Başvuran Hastaların Analizi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, c. 50, sy. 2, 2024, ss. 257-61, doi:10.32708/uutfd.1513408.
Vancouver Karakaş Uslusoy D, Durak VA, Uslusoy İ, Aydoğan G, Çıkrıklar Hİ. COVID-19 Pandemi Sürecinde Serebrovasküler Hastalık Tanısı ile Acil Servise Başvuran Hastaların Analizi. Uludağ Tıp Derg. 2024;50(2):257-61.

ISSN: 1300-414X, e-ISSN: 2645-9027

Uludağ Üniversitesi Tıp Fakültesi Dergisi "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License" ile lisanslanmaktadır.


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Journal of Uludag University Medical Faculty is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

2023