RESUMO
Resumen La pandemia por COVID-19 y el aislamiento social preventivo y obligatorio (ASPO) han generado cambios en la organización y utilización del sistema de salud en todo el mundo. Analizamos el impacto de la situación sanitaria en el número de consultas ambulatorias, internaciones y acceso a terapias de revascularización por enfermedad cerebrovascular. Se analizó el período desde el 1 marzo al 31 de julio de 2020. Se comparó con el mismo período de 2019. Se evaluaron total de consultas ambulatorias e internaciones, escala NIHSS (National Institute of Health Stroke Scale) al ingreso, tipo de enfermedad cerebrovascular y uso de terapias de revascularización. Ingresaron 197 pacientes con eventos cerebrovasculares agudos en 2019 y 150 pacientes en 2020. Hubo un descenso significativo en el número de internaciones por eventos isquémicos totales y accidentes isquémico transitorios en el comparativo de los 5 meses. Se vio además un aumento en trombosis venosas cerebrales y hemorragias cerebrales. El acceso a fibrinolisis intravenosa y trombectomía mecánica se mantuvo estable, pero con prolongación del tiempo puerta-aguja. Las consultas ambulatorias descendieron 67%, siendo mayor el descenso en abril y más marcado en consultas de seguimiento. El número de internaciones y de consultas ambulatorias durante el ASPO descendió sustancialmente. Esto pareciera obedecer al cumplimiento estricto de la cuarentena y no a mecanismos fisiopatológicos relacionados con el COVID-19. Debe educarse a la población sobre la necesidad del control de enfermedades crónicas y de eventos agudos y se deben garantizar medidas de seguridad en los centros de salud.
Abstract The COVID-19 pandemic and preventive and compulsory social isolation (PCSI) have generated changes in the organization and use of the health system around the world. We analyze the impact of the health situation on the number of outpatient visits, hospitalizations and access to revascularization therapy for cerebrovascular disease. The period from March 1 to July 31, 2020 was analyzed. It was compared with the same period in 2019. Total outpatient and hospital visits were evaluated, NIHSS scale (National Institute of Health Stroke Scale) upon admission, type of cerebrovascular disease and use of revascularization therapies; 197 patients with acute cerebrovascular events were admitted in 2019 and 150 patients in 2020. There was a significant decrease in the number of hospitalizations for total ischemic events and transient ischemic attacks in the comparison of 5 months. An increase in cerebral venous thrombosis and cerebral hemorrhages was also seen. Access to intravenous fibrinolysis and mechanical thrombectomy remained stable, but with prolonged door-to-needle time. Outpatient visits fell 67%, the decrease being greater in April and more marked in follow-up visits. The number of hospitalizations and outpatient visits during the PCSI dropped substantially. This seems to be due to strict compliance with quarantine and not to pathophysiological mechanisms related to COVID-19. The population should be educated about the need to control chronic diseases and acute events and safety measures should be guaranteed in health centers.
Assuntos
Humanos , Acidente Vascular Cerebral/prevenção & controle , Acidente Vascular Cerebral/epidemiologia , COVID-19 , Pacientes Ambulatoriais , Argentina/epidemiologia , Isolamento Social , Pandemias , SARS-CoV-2 , HospitalizaçãoRESUMO
@#The Southern Philippines Medical Center (SPMC) is one of the 16 hospitals retained by the Department of Health in Mindanao.1 It has a diverse clientele, mostly coming from the Davao Region (Region XI), SOCCSKSARGEN (Region XII) and Caraga Region (Region XIII). The SPMC Outpatient Department (OPD) consists of the following specialty clinics: Dental Medicine, Dermatology, Otorhinolaryngology - Head and Neck Surgery, Family and Community Medicine, Internal Medicine, Obstetrics & Gynecology, Ophthalmology, Orthopedics, Pediatrics, Physical Therapy and Rehabilitation Medicine, General Surgery, Urology, Cancer Institute, Heart Institute, Institute of Psychiatry and Behavioral Medicine, and Animal Bite and Treatment Center.2 This infographic shows the number of outpatient consultations in SPMC from January to December 2017, which totalled 449,355. The three outpatient departments with the highest numbers of outpatient consultations were: Family and Community Medicine (64,388 consultations), Obstetrics & Gynecology (58,757 consultations), and Internal Medicine (53,270 consultations). SPMC will expand its services in the future with the construction of the institutes or centers for Women and Newborn Health, Cancer, Kidney and Transplant, Orthopedics, Ophthalmology, Dermatology, Pediatrics, and Acute Care and Trauma. Each of these centers is projected to also run its own specialized outpatient services.
Assuntos
Pacientes AmbulatoriaisRESUMO
@#The Southern Philippines Medical Center (SPMC) is one of the 16 hospitals retained by the Department of Health in Mindanao.1 It has a diverse clientele, mostly coming from the Davao Region (Region XI), SOCCSKSARGEN (Region XII) and Caraga Region (Region XIII). The SPMC Outpatient Department (OPD) consists of the following specialty clinics: Dental Medicine, Dermatology, Otorhinolaryngology - Head and Neck Surgery, Family and Community Medicine, Internal Medicine, Obstetrics & Gynecology, Ophthalmology, Orthopedics, Pediatrics, Physical Therapy and Rehabilitation Medicine, General Surgery, Urology, Cancer Institute, Heart Institute, Institute of Psychiatry and Behavioral Medicine, and Animal Bite and Treatment Center.2 This infographic shows the number of outpatient consultations in SPMC from January to December 2017, which totalled 449,355. The three outpatient departments with the highest numbers of outpatient consultations were: Family and Community Medicine (64,388 consultations), Obstetrics & Gynecology (58,757 consultations), and Internal Medicine (53,270 consultations). SPMC will expand its services in the future with the construction of the institutes or centers for Women and Newborn Health, Cancer, Kidney and Transplant, Orthopedics, Ophthalmology, Dermatology, Pediatrics, and Acute Care and Trauma. Each of these centers is projected to also run its own specialized outpatient services.