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Alarming downtrend in mechanical thrombectomy rates in African American patients during the COVID-19 pandemic-Insights from STAR.
Al Kasab, Sami; Almallouhi, Eyad; Alawieh, Ali; Jabbour, Pascal; Sweid, Ahmad; Starke, Robert M; Saini, Vasu; Wolfe, Stacey Q; Fargen, Kyle M; Arthur, Adam S; Goyal, Nitin; Pandhi, Abhi; Maier, Ilko; Grossberg, Jonathan A; Howard, Brian M; Tjoumakaris, Stavropoula I; Rai, Ansaar; Park, Min S; Mascitelli, Justin R; Psychogios, Marios N; Spiotta, Alejandro M.
  • Almallouhi E; Neurosurgery, Medical University of South Carolina, Charleston, SC, USA.
  • Alawieh A; Neurology, Medical University of South Carolina, Charleston, SC, USA.
  • Jabbour P; Neurosurgery, Emory University, Atlanta, GA, USA.
  • Sweid A; Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA.
  • Starke RM; Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
  • Saini V; Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
  • Wolfe SQ; Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
  • Fargen KM; Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
  • Arthur AS; Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
  • Goyal N; Neurosurgery, Wake Forest University, Winston-Salem, NC, USA.
  • Pandhi A; Neurosurgery, Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA.
  • Maier I; Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
  • Grossberg JA; Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
  • Howard BM; Neurology, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA.
  • Tjoumakaris SI; Neurology, University Medicine Goettingen, Goettingen, NS, Germany.
  • Rai A; Neurosurgery and Radiology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Park MS; Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Mascitelli JR; Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Psychogios MN; Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
  • Spiotta AM; Radiology, West Virginia University Hospitals, Morgantown, West Virginia, USA.
J Neurointerv Surg ; 13(4): 304-307, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1013062
Semantic information from SemMedBD (by NLM)
1. Mechanical thrombectomy TREATS Patients
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Patients
2. Cerebrovascular accident PROCESS_OF Patients
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Patients
3. Mechanical thrombectomy ADMINISTERED_TO Patients
Subject
Mechanical thrombectomy
Predicate
ADMINISTERED_TO
Object
Patients
4. Acute Cerebrovascular Accidents PROCESS_OF Patients
Subject
Acute Cerebrovascular Accidents
Predicate
PROCESS_OF
Object
Patients
5. Mechanical thrombectomy TREATS Acute Cerebrovascular Accidents
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Acute Cerebrovascular Accidents
6. Blood Vessel LOCATION_OF risk factors
Subject
Blood Vessel
Predicate
LOCATION_OF
Object
risk factors
7. Mechanical thrombectomy TREATS Cerebrovascular accident
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Cerebrovascular accident
8. Mechanical thrombectomy TREATS Patients
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Patients
9. Cerebrovascular accident PROCESS_OF Patients
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Patients
10. Mechanical thrombectomy ADMINISTERED_TO Patients
Subject
Mechanical thrombectomy
Predicate
ADMINISTERED_TO
Object
Patients
11. Acute Cerebrovascular Accidents PROCESS_OF Patients
Subject
Acute Cerebrovascular Accidents
Predicate
PROCESS_OF
Object
Patients
12. Mechanical thrombectomy TREATS Acute Cerebrovascular Accidents
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Acute Cerebrovascular Accidents
13. Blood Vessel LOCATION_OF risk factors
Subject
Blood Vessel
Predicate
LOCATION_OF
Object
risk factors
14. Mechanical thrombectomy TREATS Cerebrovascular accident
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Cerebrovascular accident
ABSTRACT

BACKGROUND:

The coronavirus disease (COVID-19) pandemic has affected stroke care globally. In this study, we aim to evaluate the impact of the current pandemic on racial disparities among stroke patients receiving mechanical thrombectomy (MT).

METHODS:

We used the prospectively collected data in the Stroke Thrombectomy and Aneurysm Registry from 12 thrombectomy-capable stroke centers in the US and Europe. We included acute stroke patients who underwent MT between January 2017 and May 2020. We compared baseline features, vascular risk factors, location of occlusion, procedural metrics, complications, and discharge outcomes between patients presenting before (before February 2020) and those who presented during the pandemic (February to May 2020).

RESULTS:

We identified 2083 stroke patients of those 235 (11.3%) underwent MT during the COVID-19 pandemic. Compared with pre-pandemic, stroke patients who received MT during the pandemic had longer procedure duration (44 vs 38 min, P=0.006), longer length of hospitalization (6 vs 4 days, P<0.001), and higher in-hospital mortality (18.7% vs 11%, P<0.001). Importantly, there was a lower number of African American patients undergoing MT during the COVID-19 pandemic (609 (32.9%) vs 56 (23.8%); P=0.004).

CONCLUSION:

The COVID-19 pandemic has affected the care process for stroke patients receiving MT globally. There is a significant decline in the number of African American patients receiving MT, which mandates further investigation.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: African Americans / Thrombectomy / Stroke / Healthcare Disparities / Pandemics / COVID-19 Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: J Neurointerv Surg Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: African Americans / Thrombectomy / Stroke / Healthcare Disparities / Pandemics / COVID-19 Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: J Neurointerv Surg Year: 2021 Document Type: Article