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– Drastic decline in stroke patients

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For March, April and May, the decline on a national basis is as much as 13 percent. In some places as much as 25 percent.

– We have never seen such a decline before, Hild Fjærtoft tells Dagbladet.

She is an associate professor at NTNU and general manager of the Norwegian Stroke Register, which registers confirmed strokes from all of the country’s 51 hospitals.

100 fewer a month

In 2019, a total of 2256 stroke victims visited the Norwegian health service in March, April and May. In 2020, the number is 1973 patients in the same period.

– On average, there has been a reduction of 100 stroke patients a month. It is relatively much considering that this is a serious disease.

WILL FIND THE CAUSE: Hild Fjærtoft is the general manager of the Norwegian Stroke Register, and says that they will try to find the reason why the number of stroke patients has dropped drastically during the corona pandemic. Photo: NTNU
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Earlier this week, Dagbladet wrote that new research also shows that far fewer have been admitted with acute myocardial infarction both in Norway and other European countries.

At the beginning of the pandemic, several hospitals called for a warning about the decline in the number of heart and stroke patients, and emphasized how important it was for these patients to get to hospital.

– We still wonder if there are people at home who have not made contact after mild strokes, says chief physician Hege Ihle-Hansen at the section for stroke at Oslo University Hospital Ullevål to Dagbladet.

MAY HAVE BEEN HOME: The hospitals experienced a large decline in both heart and stroke patients in the first months of the corona pandemic. One of the explanations may be that people refused to go to the health service. Photo: Gorm Kallestad / NTB
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New everyday life

However, she believes that it may also be about people having a slightly different everyday life.

– That the pace has slowed down and the new lifestyle has reduced the incidence. We are also seeing a decline in infections in general, and that people have become less ill. There are fewer admissions at all, says Ihle-Hansen.

Also at the Section for Stroke at OUS, they have also seen a marked decrease in the number of admissions. Looking at Europe, similar trends are also reported. However, the cause is still uncertain, and the Norwegian Stroke Register will try to find answers through a study they have on the way.

NEW EVERYDAY LIFE: Hege Ihle-Hansen is chief physician at the Section for Stroke at Ullevål Hospital. She believes that the new everyday life the coronavirus gave us may have caused fewer people to have strokes. Photo: Arnljot Tveit / Vestre Viken
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– We do not know if there are actually fewer who have had a stroke, or if there are fewer who have sought health care. We can not rule out that there has actually been a real decline because our life situation suddenly changed, but I have no evidence to say anything about it today, says Fjærtoft.

Possible normalization

If it is in fact patients with mild strokes who have failed to consult the health service, this may also have an effect over time.

– We will have the opportunity to look at hospitalization rates later, whether it is actually patients who have not made contact and thus have not received good secondary prevention – ie prevention against new strokes.

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– How has the situation been from June until today?

– It looks like it has returned to normal, although we can not say this with certainty until we have received all entries in the medical quality register.

Fjærtoft believes this may be related to the fact that the health service this spring was clear that seriously ill people had to seek help, in addition to the corona admissions declining and society being gradually reopened.

– But it is too early to conclude here.

The planned study will also take a closer look at whether stroke patients waited too long to visit a hospital, and whether it may have had undesirable consequences for treatment results and later functional level, says Fjærtoft.


Insane reduction after lockdown

Fewer admissions in general

Challenging corona everyday

The section for stroke at OUS developed the offer to include patients from all over Oslo in May 2019. During its first year, the ward had 2,700 patients with suspected stroke, making it one of the wards with the highest number of acute patients. In an unclear corona situation, they therefore had to adjust quickly and double the capacity in reception, so that one team could work close to the patient while another took care of sampling and diagnostics.

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– It can have major consequences for survival if a stroke patient does not receive treatment quickly. We were very clear that the emergency loops had to be maintained as part of the pandemic preparedness, says Ihle-Hansen.

– Everyone who came in with a suspected stroke was also treated as a suspected corona patient, and they were isolated until it was refuted. The advantage today is better testing and faster test results, so that we can now strip the patient faster.

This means that stroke patients in the current corona situation have better access to their relatives.

– Getting a brain disease is very dramatic. What I think has been most difficult is not being able to have that closeness to relatives, and it was an exercise to ensure that they were taken care of, says Ihle-Hansen.

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