International Experience of Mechanical Thrombectomy During the COVID-19 Pandemic: Insights from STAR and ENRG

Autor: Clemens M. Schirmer, Sharon Webb, Shakeel Chowdry, Albert J Yoo, Andrew F. Ducruet, Ansaar T Rai, Andrew W. Grande, Stacey Q Wolfe, Min S. Park, Nitin Goyal, Richard Williamson, Jonathan A Grossberg, Peter Kan, Santiago Gomez-Paz, R. Webster Crowley, Ahmad Sweid, Ilko Maier, Waldo R. Guerrero, Christopher S. Ogilvy, Abhi Pandhi, Muhammad Ubaid Hafeez, Marios Psychogios, Kyle M Fargen, Alejandro M Spiotta, Stavropoula Tjoumakaris, Michael R. Levitt, William J. Ares, Justin R Mascitelli, Ali Alawieh, Robert M. Starke, Charles C. Matouk, Brian M. Howard, Pascal Jabbour, Krishna C Joshi, Sami Al Kasab, Roberto Crosa, Andrew J. Ringer, Maxim Mokin, Vasu Saini, Isabel Fragata, Eyad Almallouhi, Adam S Arthur, Christine A Holmstedt
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
medicine.medical_treatment
030204 cardiovascular system & hematology
Workflow
0302 clinical medicine
Pandemic
Thrombectomy / statistics & numerical data
Medicine
Intubation
Hospital Mortality
Prospective Studies
Stroke
Thrombectomy
Aged
80 and over
Confounding
Endovascular Procedures
General Medicine
Middle Aged
stroke
Thrombectomy / methods
Treatment Outcome
Female
Independent Living
Coronavirus Infections
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19)
Stroke / therapy
Pneumonia
Viral
HSJ NRAD
complication
Anesthesia
General
03 medical and health sciences
Humans
Pandemics
Ischemic Stroke
Aged
business.industry
Link function
COVID-19
medicine.disease
Triage
Mechanical thrombectomy
Emergency medicine
Reperfusion
Linear Models
Surgery
Neurology (clinical)
business
030217 neurology & neurosurgery
Zdroj: Journal of Neurointerventional Surgery
Popis: BackgroundIn response to the COVID-19 pandemic, many centers altered stroke triage protocols for the protection of their providers. However, the effect of workflow changes on stroke patients receiving mechanical thrombectomy (MT) has not been systematically studied.MethodsA prospective international study was launched at the initiation of the COVID-19 pandemic. All included centers participated in the Stroke Thrombectomy and Aneurysm Registry (STAR) and Endovascular Neurosurgery Research Group (ENRG). Data was collected during the peak months of the COVID-19 surge at each site. Collected data included patient and disease characteristics. A generalized linear model with logit link function was used to estimate the effect of general anesthesia (GA) on in-hospital mortality and discharge outcome controlling for confounders.Results458 patients and 28 centers were included from North America, South America, and Europe. Five centers were in high-COVID burden counties (HCC) in which 9/104 (8.7%) of patients were positive for COVID-19 compared with 4/354 (1.1%) in low-COVID burden counties (LCC) (PConclusionWe observed a low rate of COVID-19 infection among stroke patients undergoing MT in LCC. Overall, more than half of the patients underwent intubation prior to MT, leading to prolonged door to reperfusion time, higher in-hospital mortality, and lower likelihood of functional independence at discharge.
Databáze: OpenAIRE
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