- The Impact of COVID-19 on Admissions and In-hospital Mortality of Patients With Stroke in Korea: An Interrupted Time Series Analysis
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Youngs Chang, Soo-Hee Hwang, Haibin Bai, Seowoo Park, Eunbyul Cho, Dohoung Kim, Hyejin Lee, Jin Yong Lee
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J Prev Med Public Health. 2025;58(1):60-71. Published online October 28, 2024
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DOI: https://doi.org/10.3961/jpmph.24.432
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 Abstract
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- Objectives
This study aimed to investigate the impact of coronavirus disease 2019 (COVID-19) on admission rates and in-hospital mortality among patients with ischemic and hemorrhagic stroke.
Methods
We constructed a dataset detailing the monthly hospitalizations and mortality rates of inpatients with stroke from January 2017 to December 2021. Employing an interrupted time series analysis, we explored the impact of COVID-19 on hospitalizations and 30-day in-hospital mortality among stroke patients.
Results
The number of ischemic stroke admissions decreased by 18.5%, from 5335 to 4348, immediately following the COVID-19 outbreak (p<0.001). The in-hospital mortality rate for ischemic stroke increased slightly from 3.3% to 3.4% immediately after the outbreak, although it showed a decreasing trend over time. The number of hemorrhagic stroke admissions fell by 7.5%, from 2014 to 1864, immediately following the COVID-19 outbreak. The 30-day in-hospital mortality rate for hemorrhagic stroke initially decreased from 12.9% to 12.7%, but subsequently showed an increasing trend.
Conclusions
We confirmed that COVID-19 impacted both the admission and death rates of stroke patients. The admission rate for both ischemic and hemorrhagic strokes decreased, while in-hospital mortality increased. Specifically, in-hospital mortality from ischemic stroke rose initially after the outbreak before stabilizing. Additionally, our findings indicate variable effects based on sex, age, and socioeconomic status, suggesting that certain groups may be more susceptible. This underscores the need to identify and support vulnerable populations to mitigate adverse health outcomes.
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Summary
Korean summary
국민건강보험공단 데이터베이스를 자료원으로 하고 ITS 분석을 실시하여 코로나19가 뇌졸중 환자의 입원 및 30일 내 사망률에 미치는 영향을 조사했습니다. 그 결과 코로나19가 뇌졸중 환자의 입원율과 사망률에 모두 영향을 미친다는 사실을 확인했습니다. 특히, 75세 이상과 의료급여 수급자의 허혈성 및 출혈성 뇌졸중 입원율이 감소한 것으로 나타났습니다.
Key Message
Employing an interrupted time series analysis, we explored the impact of COVID-19 on hospitalizations and 30-day in-hospital mortality among stroke patients using the National Health Insurance Service Database. We confirmed that COVID-19 impacted both the admission and death rates of stroke patients. Specifically, ischemic and hemorrhagic stroke admission rates decreased among individuals over 75 and MA beneficiaries.
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Citations
Citations to this article as recorded by  - Who Dies Alone? Demographics, Underlying Diseases, and Healthcare Utilization Patterns of Lonely Death Individuals in Korea
Haibin Bai, Jae-ryun Lee, Min Jung Kang, Young-Ho Jun, Hye Yeon Koo, Jieun Yun, Jee Hoon Sohn, Jin Yong Lee, Hyejin Lee
Journal of Preventive Medicine and Public Health.2025; 58(2): 218. CrossRef
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