在COVID-19大流行期间,中风和STEMI管理中的社会和临床脆弱性:基于注册表的研究
Emilie Lesaine1,2, Florence Francis2,3, Sandrine Domecq4,2
1CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France emilie.lesaine@u-bordeaux.fr.
BMJ open
|January 3, 2024
概括
随着COVID-19的流行,对易受中风和STEMI患者的护理并没有变得更糟,这揭示了之前存在的护理不平等. 在危机期间,急救途径仍然结构化,对于这些患者群体没有观察到任何重大变化.
科学领域:
- 神经科学是一个神经科学.
- 心脏病学 心脏病学
- 公共卫生 公共卫生
背景情况:
- 弱势群体,包括中风和ST段升高心肌梗塞 (STEMI) 患者,可能在医疗保健获取和质量方面面临差异.
- COVID-19大流行给全球医疗保健系统带来了前所未有的挑战,可能会影响重症患者的护理.
研究的目的:
- 评估COVID-19流行病的第一波是否加剧了社会和临床上脆弱的中风和STEMI患者的现有护理质量问题.
- 分析大流行对这些脆弱患者群体的护理管理时间的影响.
主要方法:
- 一项回顾性研究分析了阿基坦尼神经心血管注册表 (2019年1月 - 2020年8月) 的数据.
- 涉及6个紧急医疗服务和相关设施的9218名患者 (6436名中风,2782名STEMI).
- 多变量线性混合模型被用来分析护理管理时间 (例如,STEMI的首次医疗接触到程序,中风的急诊室入院到成像) 与患者的脆弱性 (社会剥夺,年龄,神经心血管病史) 相关,在波前,波后和波后期间.
主要成果:
- 在脆弱的STEMI患者 (老年人,处于社会不利地位) 中,已经存在的护理管理时间不平等被确定.
- 在STEMI或中风患者的COVID-19波和护理管理时间之间没有发现关于年龄,神经心血管病史或剥夺的显著相互作用.
- 对中风患者的护理管理时间与研究的脆弱性或流行病时期没有显著的关联.
结论:
- 在COVID-19第一波期间,易受STEMI和中风患者的现有医疗保健不平等没有显著改变.
- 实施的危机措施并没有对这些关键患者群体建立的紧急护理途径产生负面影响.
- 该研究强调了结构化紧急通道的弹性,尽管存在与流行病有关的中断.
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