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International Survey of Mechanical Thrombectomy Stroke Systems of Care During COVID-19 Pandemic.
Yavagal, Dileep R; Saini, Vasu; Inoa, Violiza; Gardener, Hannah E; Martins, Sheila O; Fakey, Manav; Ortega, Santiago; Mansour, Ossama; Leung, Thomas; Al-Mufti, Fawaz; Jadhav, Ashutosh P; Potter-Vig, Jennifer; Mairal, Anurag; Zhongrong, Miao; Sylaja, P N; Demchuk, Andrew M.
  • Yavagal DR; University of Miami Miller School of Medicine, Miami, FL, United States. Electronic address: DYavagal@med.miami.edu.
  • Saini V; University of Miami Miller School of Medicine, Miami, FL, United States.
  • Inoa V; Semmes-Murphey Clinic, Memphis, TN, United States.
  • Gardener HE; University of Miami Miller School of Medicine, Miami, FL, United States.
  • Martins SO; University Federal of Rio Grande do Sul, Hosp de Clínicas de Porto Alegre, Porto Alegre, Brazil.
  • Fakey M; Orbees Medical, Delhi, India.
  • Ortega S; University of Iowa Hosp, Iowa City, IA, United States.
  • Mansour O; Alexandria University Hospital, Alexandria, Egypt.
  • Leung T; The Chinese University of Hong Kong, Hong Kong.
  • Al-Mufti F; New York Medical College, Valhalla, NY, United States.
  • Jadhav AP; Barrow Brain and Spine Institute, Phoenix, AZ, United States.
  • Potter-Vig J; Society of Vascular and Interventional Neurology, St. Cloud, MN, United States.
  • Mairal A; Stanford University, Stanford, CA, United States.
  • Zhongrong M; Beijing Tiantan Hospital, Beijing, China.
  • Sylaja PN; Sree Chitra Tirunal Inst for Medical Sciences and Technology, Trivandrum, India.
  • Demchuk AM; University of Calgary, Calgary, AB, Canada.
J Stroke Cerebrovasc Dis ; 30(8): 105806, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1171234
ABSTRACT

BACKGROUND:

The COVID-19 pandemic has strained the healthcare systems across the world but its impact on acute stroke care is just being elucidated. We hypothesized a major global impact of COVID-19 not only on stroke volumes but also on various aspects of thrombectomy systems.

AIMS:

We conducted a convenience electronic survey with a 21-item questionnaire aimed to identify the changes in stroke admission volumes and thrombectomy treatment practices seen during a specified time period of the COVID-19 pandemic.

METHODS:

The survey was designed using Qualtrics software and sent to stroke and neuro-interventional physicians around the world who are part of the Global Executive Committee (GEC) of Mission Thrombectomy 2020, a global coalition under the aegis of Society of Vascular and Interventional Neurology, between April 5th and May 15th, 2020.

RESULTS:

There were 113 responses to the survey across 25 countries with a response rate of 31% among the GEC members. Globally there was a median 33% decrease in stroke admissions and a 25% decrease in mechanical thrombectomy (MT) procedures during the COVID-19 pandemic period until May 15th, 2020 compared to pre-pandemic months. The intubation policy for MT procedures during the pandemic was highly variable across participating centers 44% preferred intubating all patients, including 25% of centers that changed their policy to preferred-intubation (PI) from preferred non-intubation (PNI). On the other hand, 56% centers preferred not intubating patients undergoing MT, which included 27% centers that changed their policy from PI to PNI. There was no significant difference in rate of COVID-19 infection between PI versus PNI centers (p=0.60) or if intubation policy was changed in either direction (p=1.00). Low-volume (<10 stroke/month) compared with high-volume stroke centers (>20 strokes/month) were less likely to have neurointerventional suite specific written personal protective equipment protocols (74% vs 88%) and if present, these centers were more likely to report them to be inadequate (58% vs 92%).

CONCLUSION:

Our data provides a comprehensive snapshot of the impact on acute stroke care observed worldwide during the pandemic. Overall, respondents reported decreased stroke admissions as well as decreased cases of MT with no clear preponderance in intubation policy during MT. DATA ACCESS STATEMENT The corresponding author will consider requests for sharing survey data. The study was exempt from institutional review board approval as it did not involve patient level data.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Practice Patterns, Physicians&apos; / Global Health / Thrombectomy / Stroke / Healthcare Disparities / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: J Stroke Cerebrovasc Dis Journal subject: Vascular Diseases / Brain Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Practice Patterns, Physicians&apos; / Global Health / Thrombectomy / Stroke / Healthcare Disparities / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: J Stroke Cerebrovasc Dis Journal subject: Vascular Diseases / Brain Year: 2021 Document Type: Article