Treatment and Outcomes of Patients With Ischemic Stroke During COVID-19: An Analysis From Get With The Guidelines-Stroke
| Autor: | Christine Rutan, James A. de Lemos, Steve R. Messe, Brooke Alhanti, Joseph H. Williams, Shuaiqi Zhang, Ying Xian, Jason G. Walchok, Heather M. Alger, Mitchell S.V. Elkind, Marquita Decker-Palmer, Pratyaksh K. Srivastava, Lee H. Schwamm, Eric E. Smith, Gregg C. Fonarow, Hanzhang Xu |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19) Original Contributions Clinical Sciences coronavirus Quality care 030204 cardiovascular system & hematology Stroke care pandemics tomography Cardiorespiratory Medicine and Haematology inpatient 03 medical and health sciences Clinical and Population Sciences 0302 clinical medicine Pandemic ischemic stroke Medicine Humans Stroke ComputingMilieux_MISCELLANEOUS Advanced and Specialized Nursing Inpatient mortality Neurology & Neurosurgery business.industry Prevention Rehabilitation Neurosciences COVID-19 Odds ratio medicine.disease Brain Disorders Treatment Outcome Ischemic stroke Emergency medicine Practice Guidelines as Topic ComputingMethodologies_DOCUMENTANDTEXTPROCESSING Neurology (clinical) Guideline Adherence Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery |
| Zdroj: | Stroke, vol 52, iss 10 Stroke |
| Popis: | Supplemental Digital Content is available in the text. Background and Purpose: The coronavirus disease 2019 (COVID-19) pandemic has created challenges in the delivery of acute stroke care. In this study, we analyze the characteristics, evaluation, treatment, and in-hospital outcomes of patients presenting with acute ischemic stroke (AIS) pre-COVID-19 and during COVID-19. Methods: Get With The Guidelines-Stroke is a national registry of adults with stroke in the United States. Using this registry, we identified patients with a diagnosis of AIS before (n=39 113; November 1, 2019–February 3, 2020) and after (n=41 971; February 4, 2020–June 29, 2020) the first reported case of COVID-19 in the registry. Characteristics, treatment patterns, quality metrics, and in-hospital outcomes were compared between the 2 groups. Results: Stroke presentations decreased by an average of 15.3% per week in the during COVID-19 time period when compared with similar months in 2019. Compared with patients with AIS in the pre-COVID-19 era, patients in the COVID-19 time period had similar rates of intravenous alteplase and endovascular therapy, and similar door to computed tomography, door to needle, and door to endovascular therapy times. In adjusted models, inpatient mortality was similar between those presenting with AIS pre-COVID-19 and during COVID-19 (4.8% versus 5.2%; odds ratio, 1.05 [95% CI, 0.97–1.13]). Conclusions: Among hospitals participating in Get With The Guidelines-Stroke, patients presenting with AIS during COVID-19 received, with few exceptions, similar quality care and experienced similar risk-adjusted outcomes when compared with patients with AIS presenting pre-COVID-19. These findings demonstrate that stroke care in the United States remains robust during the COVID-19 pandemic. |
| Databáze: | OpenAIRE |
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