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Hospital admissions of acute cerebrovascular diseases during and after the first wave of the COVID-19 pandemic: a state-wide experience from Austria
We investigated hospital admission rates for the entire spectrum of acute cerebrovascular diseases and of recanalization treatments for ischaemic stroke (IS) in the Austrian federal state of Styria during and also after the first coronavirus disease 2019 (COVID-19) wave. We retrospectively identifie...
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| Published in: | Journal of neurology 2021-10, Vol.268 (10), p.3584-3588 |
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| container_title | Journal of neurology |
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| creator | Gattringer, Thomas Fandler-Höfler, Simon Kneihsl, Markus Hofer, Edith Köle, Wolfgang Schmidt, Reinhold Tscheliessnigg, Karl-Heinz Frank, Almut-Michaela Enzinger, Christian |
| description | We investigated hospital admission rates for the entire spectrum of acute cerebrovascular diseases and of recanalization treatments for ischaemic stroke (IS) in the Austrian federal state of Styria during and also after the first coronavirus disease 2019 (COVID-19) wave. We retrospectively identified all patients with transient ischaemic attack (TIA), IS and non-traumatic intracranial haemorrhage (ICH; including intracerebral, subdural and subarachnoid bleeding types) admitted to one of the 11 public hospitals in Styria (covering > 95% of inhospital cerebrovascular events in this region). Information was extracted from the electronic medical documentation network connecting all public Styrian hospitals. We analysed two periods of interest: (1) three peak months of the first COVID-19 wave (March–May 2020), and (2) three recovery months thereafter (June–August 2020), compared to respective periods 4 years prior (2016–2019) using Poisson regression. In the three peak months of the first COVID-19 wave, there was an overall decline in hospital admissions for acute cerebrovascular diseases (RR = 0.83, 95% CI 0.78–0.89,
p
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| doi_str_mv | 10.1007/s00415-021-10488-8 |
| format | article |
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p
< 0.001), which was significant for TIA (RR = 0.61, 95% CI 0.52–0.72,
p
< 0.001) and ICH (0.78, 95% CI 0.67–0.91,
p
= 0.02), but not for IS (RR = 0.93, 95% CI 0.85–1,
p
= 0.08). Thrombolysis and thrombectomy numbers were not different compared to respective months 4 years prior. In the recovery period after the first COVID-19 wave, TIA (RR = 0.82, 95% CI 0.71–0.96,
p
= 0.011) and ICH (RR = 0.86, 95% CI 0.74–0.99,
p
= 0.045) hospitalizations remained lower, while the frequency of IS and recanalization treatments was unchanged. In this state-wide analysis covering all types of acute cerebrovascular diseases, hospital admissions for TIA and ICH were reduced during and also after the first wave of the COVID-19 pandemic, but hospitalizations and recanalization treatments for IS were not affected in these two periods.</description><identifier>ISSN: 0340-5354</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-021-10488-8</identifier><identifier>PMID: 33641003</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Austria - epidemiology ; Brain Ischemia ; Cerebrovascular diseases ; Cerebrovascular Disorders - epidemiology ; Cerebrovascular Disorders - therapy ; Coronaviruses ; COVID-19 ; Hemorrhage ; Hospitalization ; Hospitals ; Humans ; Ischemia ; Medicine ; Medicine & Public Health ; Neurology ; Neuroradiology ; Neurosciences ; Pandemics ; Patient admissions ; Retrospective Studies ; SARS-CoV-2 ; Short ; Short Commentary ; Stroke - epidemiology ; Stroke - therapy ; Thrombolysis ; Transient ischemic attack ; Vascular diseases</subject><ispartof>Journal of neurology, 2021-10, Vol.268 (10), p.3584-3588</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-ac2c002f4571ab353367765bc27227fe9f2a5cdf6c2d985ca2c87ad7951324b33</citedby><cites>FETCH-LOGICAL-c474t-ac2c002f4571ab353367765bc27227fe9f2a5cdf6c2d985ca2c87ad7951324b33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,786,790,891,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33641003$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gattringer, Thomas</creatorcontrib><creatorcontrib>Fandler-Höfler, Simon</creatorcontrib><creatorcontrib>Kneihsl, Markus</creatorcontrib><creatorcontrib>Hofer, Edith</creatorcontrib><creatorcontrib>Köle, Wolfgang</creatorcontrib><creatorcontrib>Schmidt, Reinhold</creatorcontrib><creatorcontrib>Tscheliessnigg, Karl-Heinz</creatorcontrib><creatorcontrib>Frank, Almut-Michaela</creatorcontrib><creatorcontrib>Enzinger, Christian</creatorcontrib><title>Hospital admissions of acute cerebrovascular diseases during and after the first wave of the COVID-19 pandemic: a state-wide experience from Austria</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>We investigated hospital admission rates for the entire spectrum of acute cerebrovascular diseases and of recanalization treatments for ischaemic stroke (IS) in the Austrian federal state of Styria during and also after the first coronavirus disease 2019 (COVID-19) wave. We retrospectively identified all patients with transient ischaemic attack (TIA), IS and non-traumatic intracranial haemorrhage (ICH; including intracerebral, subdural and subarachnoid bleeding types) admitted to one of the 11 public hospitals in Styria (covering > 95% of inhospital cerebrovascular events in this region). Information was extracted from the electronic medical documentation network connecting all public Styrian hospitals. We analysed two periods of interest: (1) three peak months of the first COVID-19 wave (March–May 2020), and (2) three recovery months thereafter (June–August 2020), compared to respective periods 4 years prior (2016–2019) using Poisson regression. In the three peak months of the first COVID-19 wave, there was an overall decline in hospital admissions for acute cerebrovascular diseases (RR = 0.83, 95% CI 0.78–0.89,
p
< 0.001), which was significant for TIA (RR = 0.61, 95% CI 0.52–0.72,
p
< 0.001) and ICH (0.78, 95% CI 0.67–0.91,
p
= 0.02), but not for IS (RR = 0.93, 95% CI 0.85–1,
p
= 0.08). Thrombolysis and thrombectomy numbers were not different compared to respective months 4 years prior. In the recovery period after the first COVID-19 wave, TIA (RR = 0.82, 95% CI 0.71–0.96,
p
= 0.011) and ICH (RR = 0.86, 95% CI 0.74–0.99,
p
= 0.045) hospitalizations remained lower, while the frequency of IS and recanalization treatments was unchanged. In this state-wide analysis covering all types of acute cerebrovascular diseases, hospital admissions for TIA and ICH were reduced during and also after the first wave of the COVID-19 pandemic, but hospitalizations and recanalization treatments for IS were not affected in these two periods.</description><subject>Austria - epidemiology</subject><subject>Brain Ischemia</subject><subject>Cerebrovascular diseases</subject><subject>Cerebrovascular Disorders - epidemiology</subject><subject>Cerebrovascular Disorders - therapy</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Hemorrhage</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Pandemics</subject><subject>Patient admissions</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><subject>Short</subject><subject>Short Commentary</subject><subject>Stroke - epidemiology</subject><subject>Stroke - therapy</subject><subject>Thrombolysis</subject><subject>Transient ischemic attack</subject><subject>Vascular diseases</subject><issn>0340-5354</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kctu1TAQhi0EoofCC7BAltiwCfgaJyyQqsOllSp1A2ytiTNpXSVxsJ1TeA8eGB9OKZcFK0ueb37P-CPkKWcvOWPmVWJMcV0xwSvOVNNUzT2y4UqKiivd3icbJhWrtNTqiDxK6Zox1pTCQ3IkZa1KhNyQ76chLT7DSKGffEo-zImGgYJbM1KHEbsYdpDcOkKkvU8ICRPt1-jnSwpzT2HIGGm-Qjr4mDK9gR3uE_Y324vPZ28r3tKlkDh595oCTRkyVje-R4pfF4weZ1eaY5joyZpy9PCYPBhgTPjk9jwmn96_-7g9rc4vPpxtT84rp4zKFTjhGBOD0oZDJ3XZyphad04YIcyA7SBAu36onejbRjsQrjHQm1ZzKVQn5TF5c8hd1m7C3uGcI4x2iX6C-M0G8Pbvyuyv7GXYWdNyxVRdAl7cBsTwZcWUbflDh-MIM4Y1WaHa4kU3WhT0-T_odVjjXNazQpuaM210WyhxoFwMKUUc7obhzO6l24N0W6Tbn9JtU5qe_bnGXcsvywWQByAte20Yf7_9n9gfE4W5iA</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Gattringer, Thomas</creator><creator>Fandler-Höfler, Simon</creator><creator>Kneihsl, Markus</creator><creator>Hofer, Edith</creator><creator>Köle, Wolfgang</creator><creator>Schmidt, Reinhold</creator><creator>Tscheliessnigg, Karl-Heinz</creator><creator>Frank, Almut-Michaela</creator><creator>Enzinger, Christian</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20211001</creationdate><title>Hospital admissions of acute cerebrovascular diseases during and after the first wave of the COVID-19 pandemic: a state-wide experience from Austria</title><author>Gattringer, Thomas ; 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We retrospectively identified all patients with transient ischaemic attack (TIA), IS and non-traumatic intracranial haemorrhage (ICH; including intracerebral, subdural and subarachnoid bleeding types) admitted to one of the 11 public hospitals in Styria (covering > 95% of inhospital cerebrovascular events in this region). Information was extracted from the electronic medical documentation network connecting all public Styrian hospitals. We analysed two periods of interest: (1) three peak months of the first COVID-19 wave (March–May 2020), and (2) three recovery months thereafter (June–August 2020), compared to respective periods 4 years prior (2016–2019) using Poisson regression. In the three peak months of the first COVID-19 wave, there was an overall decline in hospital admissions for acute cerebrovascular diseases (RR = 0.83, 95% CI 0.78–0.89,
p
< 0.001), which was significant for TIA (RR = 0.61, 95% CI 0.52–0.72,
p
< 0.001) and ICH (0.78, 95% CI 0.67–0.91,
p
= 0.02), but not for IS (RR = 0.93, 95% CI 0.85–1,
p
= 0.08). Thrombolysis and thrombectomy numbers were not different compared to respective months 4 years prior. In the recovery period after the first COVID-19 wave, TIA (RR = 0.82, 95% CI 0.71–0.96,
p
= 0.011) and ICH (RR = 0.86, 95% CI 0.74–0.99,
p
= 0.045) hospitalizations remained lower, while the frequency of IS and recanalization treatments was unchanged. In this state-wide analysis covering all types of acute cerebrovascular diseases, hospital admissions for TIA and ICH were reduced during and also after the first wave of the COVID-19 pandemic, but hospitalizations and recanalization treatments for IS were not affected in these two periods.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33641003</pmid><doi>10.1007/s00415-021-10488-8</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0340-5354 1432-1459 |
| language | eng |
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| subjects | Austria - epidemiology Brain Ischemia Cerebrovascular diseases Cerebrovascular Disorders - epidemiology Cerebrovascular Disorders - therapy Coronaviruses COVID-19 Hemorrhage Hospitalization Hospitals Humans Ischemia Medicine Medicine & Public Health Neurology Neuroradiology Neurosciences Pandemics Patient admissions Retrospective Studies SARS-CoV-2 Short Short Commentary Stroke - epidemiology Stroke - therapy Thrombolysis Transient ischemic attack Vascular diseases |
| title | Hospital admissions of acute cerebrovascular diseases during and after the first wave of the COVID-19 pandemic: a state-wide experience from Austria |
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