Stroke Systems of Care during the COVID-19 Epidemic in Kobe City

Autor: Yasuhisa Yoshida, Takashi Mizowaki, Ikuya Yamaura, Takeshi Takamoto, Nobuyuki Ohara, Hidehito Kimura, Kazuya Nakashima, Yoshie Hara, Nobuyuki Sakai, Yasushi Ueno, Narihide Shinoda, Chie Yanagihara, Kohkichi Hosoda, Michi Kawamoto, Hirotoshi Imamura, Yasuhiko Motooka, Hidemitsu Adachi, Kazuyuki Kuwayama
Jazyk: angličtina
Rok vydání: 2020
Předmět:
medicine.medical_specialty
Time Factors
Subarachnoid hemorrhage
Coronavirus disease 2019 (COVID-19)
Cross-sectional study
stroke systems of care
Clinical Neurology
Neurosurgical Procedures
Article
03 medical and health sciences
0302 clinical medicine
Japan
online meeting
medicine
Humans
Thrombolytic Therapy
cardiovascular diseases
Stroke
Quality Indicators
Health Care
Thrombectomy
Intracerebral hemorrhage
Delivery of Health Care
Integrated
business.industry
Cerebral infarction
Endovascular Procedures
Rehabilitation
COVID-19
medicine.disease
stroke
primary stroke center
System characteristics
Hospitalization
Cross-Sectional Studies
Treatment Outcome
Emergency response
Emergency medicine
Surgery
Neurology (clinical)
Cardiology and Cardiovascular Medicine
business
030217 neurology & neurosurgery
Zdroj: Journal of Stroke and Cerebrovascular Diseases
ISSN: 1532-8511
1052-3057
Popis: Highlights • COVID-19 epidemic challenged medical systems’ capacity to provide adequate care. • Kobe City stroke facilities operated optimally due to among-facility cooperation. • Stroke incidence decreased but treatment rates increased during the outbreak. • No case of symptomatic stroke in patients with confirmed COVID-19 was recorded.
Background The novel coronavirus disease 2019 (COVID-19) outbreak raised concerns over healthcare systems’ ability to provide suitable care to stroke patients. In the present study, we examined the provision of stroke care in Kobe City during the COVID-19 epidemic, where some major stroke centers ceased to provide emergency care. Methods This was a cross-sectional study. The Kobe Stroke Network surveyed the number of stroke patients admitted to all primary stroke centers (PSCs) in the city between March 1 and May 23, 2020, and between March 3 and May 25, 2019. In addition, online meetings between all PSC directors were held regularly to share information. The survey items included emergency response system characteristics, number of patients with stroke hospitalized within 7 days of onset, administered treatment types (IV rt-PA, mechanical thrombectomy, surgery, and endovascular therapy), and stroke patients with confirmed COVID-19. Results During the period of interest in 2020, the number of stroke patients hospitalized across 13 PSCs was 813, which was 15.5% lower than that during the same period of 2019 (p=0.285). The number of patients admitted with cerebral infarction, intracerebral hemorrhage, and subarachnoid hemorrhage decreased by 15.4% (p=0.245), 16.1% (p=0.659), and 14.0% (p=0.715), respectively. However, the rates of mechanical thrombectomy and surgery for intracerebral hemorrhage were slightly increased by 12.1% (p=0.754) and 5.0% (p=0.538), respectively. PSCs that ceased to provide emergency care reported a decrease in the number of stroke cases of 65.7% compared with the same period in 2019, while other PSCs reported an increase of 0.8%. No case of a patient with stroke and confirmed COVID-19 was reported during the study period. Conclusion Kobe City was able to maintain operation of its stroke care systems thanks to close cooperation among all city PSCs and a temporal decrease in the total number of stroke cases.
Databáze: OpenAIRE
Externí odkaz: