r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2021-26-1-15-22r-n-j-148Research ArticleИССЛЕДОВАНИЯ И КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL RESEARCHES AND CASE REPORTSАнализ смертельных случаев инсульта в региональном сосудистом центре во время пандемии COVID-19Analysis of stroke case fatality in regional stroke center during the COVID-19 pandemichttps://orcid.org/0000-0002-6256-3429ГригорьеваВ. Н.GrigoryevaV. N.

Нижний Новгород

vrgr@yandex.ruhttps://orcid.org/0000-0003-3127-8489ГузановаЕ. В.GuzanovaE. V.

Нижний Новгород

Nizhny Novgorod

el.guzanova@yandex.ruhttps://orcid.org/0000-0002-2456-7971НестероваВ. Н.NesterovaV. N.

Нижний Новгород

Nizhny Novgorod

nesterova-78@mail.ruhttps://orcid.org/0000-0001-5461-8525ЛесниковаА. А.LesnikovaA. A.

Нижний Новгород

Nizhny Novgorod

lesnikowa.alyona2018@yandex.ruhttps://orcid.org/0000-0002-6813-6321БурлаковаД. Р.BorlakovaD. R.

Нижний Новгород

Nizhny Novgorod

kavkaz-jeans@yandex.ruhttps://orcid.org/0000-0003-1782-8149КривенковаИ. С.KrivenkovaI. S.

Нижний Новгород

Nizhny Novgorod

ira.krivenkova.98@mail.ruФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава РоссииРоссияFederal State Budgetary Educational Institution of Higher Education “Privolzhsky Research Medical University” of the Ministry of Health of the Russian FederationRussian FederationФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава России; ГБУЗ НО «Нижегородская областная клиническая больница им. Н.А.Семашко»РоссияFederal State Budgetary Educational Institution of Higher Education “Privolzhsky Research Medical University” of the Ministry of Health of the Russian Federation; Nizhny Novgorod Regional Clinical Hospital named after N.A. SemashkoRussian FederationГБУЗ НО «Нижегородская областная клиническая больница им. Н.А.Семашко»РоссияNizhny Novgorod Regional Clinical Hospital named after N.A. SemashkoRussian Federation2021260320212611522Copyright © Григорьева В.Н., Гузанова Е.В., Нестерова В.Н., Лесникова А.А., Бурлакова Д.Р., Кривенкова И.С., 20212021Григорьева В.Н., Гузанова Е.В., Нестерова В.Н., Лесникова А.А., Бурлакова Д.Р., Кривенкова И.С.Grigoryeva V.N., Guzanova E.V., Nesterova V.N., Lesnikova A.A., Borlakova D.R., Krivenkova I.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/148

Цель работы — выявить особенности смертельных случаев инсульта в региональном сосудистом центре (РСЦ) в период пандемии COVID-19 для планирования мероприятий по снижению стационарной летальности. Проведен ретроспективный анализ историй болезни пациентов, умерших в остром периоде инсульта в октябре-ноябре 2019 и 2020 гг., то есть до и во время пандемии COVID-19. Возраст больных, выраженность неврологического дефицита по NIHSS и степень угнетения сознания по шкале комы Глазго на момент поступления в РСЦ в среднем не различались в 2019 и 2020 гг. Не выявлено различий в частоте встречаемости ишемического и геморрагического инсульта, представленности ранних и поздних сроков госпитализации больных, среднем времени от момента госпитализации до летального исхода, однако у больных в 2020 г. значительно чаще, чем в 2019 г., диагностировалась пневмония. В октябре-ноябре 2020 г. у 11 из 85 (12,9%) больных со смертельным случаем инсульта прижизненно был определен «вероятный» случай COVID-19. У 8 из этих 11 больных уже после летального исхода было получено лабораторное ретроспективное подтверждение COVID-19. Обнаружена связь между определением «вероятного» или ретроспективно «подтвержденного» случая COVID-19 и наличием пневмонии (р = 0,000). Основной причиной смерти больных в октябре-ноябре 2020 г. по данным патолого-анатомического исследования в 98% случаев явились инсульт и его осложнения и в 2 % случаев — тромбоэмболия легочной артерии.

The aim of the study was to analyze stroke case fatality in the regional stroke center (RSC) during the COVID-19 pandemic, in order to plan the prevention measures for reduction in mortality. A retrospective comparative analysis of the medical records of stroke patients who died in October-November 2019 and 2020, i.e. before and during the 2019 Coronavirus Disease Pandemic (COVID-19) was conducted. The age of patients, the NIHSS score and the Glasgow coma score at the admission did not differ on average in 2019 and 2020. Also, there were no differences in the incidence of ischemic and hemorrhagic stroke, the rate of early and late hospitalization, the average length of stay in the RSC prior to a lethal issue, but patients in 2020 were significantly more often diagnosed with pneumonia than in 2019. A “probable” case of COVID-19 was detected in October-November 2020 in 11 of 85 (12.9%) patients with fatal stroke before the lethal issue. In 8 of these 11 patients, laboratory confirmation of COVID-19 was obtained after the death. There was a statistically significant association between the presence of a “probable” or “confirmed” case of COVID-19 and pneumonia (Chi square 12.8, p = 0.000). According to the pathomorphological study the main cause of death in fatal stroke cases in October-November 2020 was stroke and its complications in 98% and pulmonary embolism with acute respiratory failure in 2% of cases, respectively.

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The authors declare that there are no conflicts of interest present.