Maintenance of Acute Stroke Care Service During the COVID-19 Pandemic Lockdown
| Autor: | Alessandro Pezzini, Valerian L Altersberger, Bruno Gonçalves, Jan F. Scheitz, Andreas Kastrup, Annika Nordanstig, Alessandro Padovani, Patrik Michel, Christian H. Nolte, Susanne Wegener, Marcel Arnold, Andrea Zini, Christian Hametner, Marialuisa Zedde, Peter A. Ringleb, Paul J. Nederkoorn, Ronen R. Leker, Henrik Gensicke, Georges Ntaios, Guillaume Turc, Lotte J. Stolze, Leon A. Rinkel, Stefania Nannoni, Nicolas Martinez-Majander, Georg Kägi, Leo H. Bonati, Alexandros Rentzos, Stefan T. Engelter, Charlotte Cordonnier, Carlo W. Cereda, Sami Curtze, Mauro Gentile, Hilde Hénon, Philipp Baumgartner, Visnja Padjen, Mirjam Rachel Heldner, Urs Fischer, Panagiotis Papanagiotou |
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| Přispěvatelé: | GHU Paris Psychiatrie et Neurosciences, Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Graduate School, Neurology, ACS - Atherosclerosis & ischemic syndromes, ANS - Neurovascular Disorders |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_treatment [SDV]Life Sciences [q-bio] Original Contributions 030204 cardiovascular system & hematology Severity of Illness Index Cohort Studies 0302 clinical medicine quality of care Epidemiology Pandemic Medicine Thrombolytic Therapy Registries Stroke Aged 80 and over Thrombolysis Middle Aged 3. Good health reperfusion Europe Hospitalization Treatment Outcome ComputingMethodologies_DOCUMENTANDTEXTPROCESSING Female Cardiology and Cardiovascular Medicine Cohort study medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Critical Care Physical Distancing Cardiology Time-to-Treatment 03 medical and health sciences Clinical and Population Sciences Reperfusion therapy Severity of illness ischemic stroke Humans Pandemics Aged Advanced and Specialized Nursing business.industry COVID-19 medicine.disease Emergency medicine Neurology (clinical) business 030217 neurology & neurosurgery intracranial hemorrhage |
| Zdroj: | Stroke Stroke, American Heart Association, 2021, 52 (5), pp.1693-1701. ⟨10.1161/STROKEAHA.120.032176⟩ Stroke, 52(5), 1693-1701. Lippincott Williams and Wilkins |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/STROKEAHA.120.032176⟩ |
| Popis: | Supplemental Digital Content is available in the text. Background and Purpose: Timely reperfusion is an important goal in treatment of eligible patients with acute ischemic stroke. However, during the coronavirus disease 2019 (COVID-19) pandemic, prehospital and in-hospital emergency procedures faced unprecedented challenges, which might have caused a decline in the number of acute reperfusion therapy applied and led to a worsening of key quality measures for this treatment during lockdown. Methods: This prospective multicenter cohort study used data from the TRISP (Thrombolysis in Ischemic Stroke Patients) registry of patients with acute ischemic stroke treated with reperfusion therapies, that is, intravenous thrombolysis or endovascular therapy. We compared prehospital and in-hospital time-based performance measures (stroke-onset-to-admission, admission-to-treatment, admission-to-image, and image-to-treatment time) during the first 6 weeks after announcement of lockdown (lockdown period) with the same period in 2019 (reference period). Secondary outcomes included stroke severity (National Institutes of Health Stroke Scale) after 24 hours and occurrence of symptomatic intracranial hemorrhage (following the ECASS [European-Australasian Acute Stroke Study]-II criteria). Results: Across 20 stroke centers, 540 patients were treated with intravenous thrombolysis/endovascular therapy during lockdown period compared with 578 patients during reference period (−7% [95% CI, 5%–9%]). Performance measures did not change significantly during the lockdown period (2020/2019 minutes median: onset-to-admission 133/145; admission-to-treatment 51/48). Same was true for admission-to-image (20/19) and image-to-treatment (31/30) time in patients with available time of first image (n=871, 77.9%). Median National Institutes of Health Stroke Scale on admission (2020/2019: 11/11) and after 24 hours (2020/2019: 6/5) and percentage of symptomatic intracranial hemorrhage (2020/2019: 6.2/5.7) did not differ significantly between both periods. Conclusions: The COVID-19 pandemic lockdown resulted in a mild decline in the number of patients with stroke treated with acute reperfusion therapies. More importantly, the solid stability of key quality performance measures between the 2020 and 2019 period may indicate resilience of acute stroke care service during the lockdown, at least in well-established European stroke centers. |
| Databáze: | OpenAIRE |
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