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Impact of the SARS-COV-2 Pandemic on the Endovascular Treatment of Acute Stroke - an Italian Single-Center Experience.
Pero, Guglielmo; Dória, Hugo Mota; Giavarini, Matteo; Quilici, Luca; Cervo, Amedeo; Macera, Antonio; Piano, Mariangela.
  • Pero G; Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda (Niguarda Ca' Granda), Milan, Italy. Electronic address: guglielmo.pero@ospedaleniguarda.it.
  • Dória HM; Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda (Niguarda Ca' Granda), Milan, Italy; Department of Neuroradiology, Centro Hospitalar Universitário do Porto, Porto, Portugal; Department of Neuroradiology, Hospital Central do Funchal, Rua Nova do Comboio, N. 13, Funchal, Made
  • Giavarini M; Facoltà di Medicina e Chirurgia dell'Università Statale di Milano, Milan, Italy.
  • Quilici L; Department of Neuroradiology, ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy. Electronic address: lquilici@asst-pg23.it.
  • Cervo A; Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda (Niguarda Ca' Granda), Milan, Italy. Electronic address: amedeo.cervo@ospedaleniguarda.it.
  • Macera A; Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda (Niguarda Ca' Granda), Milan, Italy.
  • Piano M; Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda (Niguarda Ca' Granda), Milan, Italy. Electronic address: mariangela.piano@ospedaleniguarda.it.
J Stroke Cerebrovasc Dis ; 30(10): 106028, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1386120
ABSTRACT

OBJECTIVES:

The SARS-CoV-2 pandemic greatly influenced the overall quality of healthcare. The purpose of this study was to compare the time variables for acute stroke treatment and evaluate differences in the pre-hospital and in-hospital care before and during the SARS-CoV-2 pandemic, as well as between the first and second waves. MATERIALS AND

METHODS:

Observational and retrospective study from an Italian hospital, including patients who underwent thrombectomy between January 1st 2019 and December 31st 2020.

RESULTS:

Out of a total of 594 patients, 301 were treated in 2019 and 293 in 2020. The majority observed in 2019 came from spoke centers (67,1%), while in 2020 more than half (52%, p < 0.01) were evaluated at the hospital's emergency room directly (ER-NCGH). When compared to 2019, time metrics were globally increased in 2020, particularly in the ER-NCGH groups during the period of the first wave (N = 24 and N = 56, respectively) "Onset-to-door"50,5 vs 88,5, p < 0,01; "Arrival in Neuroradiology - groin"13 vs 25, p < 0,01; "Door-to-groin"118 vs 143,5, p = 0,02; "Onset-to-groin"180 vs 244,5, p < 0,01; "Groin-to-recanalization" 41 vs 49,5, p = 0,03. When comparing ER-NCGH groups between the first (N = 56) and second (N = 49) waves, there was an overall improvement in times, namely in the "Door-to-CT" (47,5 vs 37, p < 0,01), "Arrival in Neuroradiology - groin" (25 vs 20, p = 0,03) and "Onset-to-groin" (244,5 vs 227,5, p = 0,02).

CONCLUSIONS:

During the SARS-CoV-2 pandemic, treatment for stroke patients was delayed, particularly during the first wave. Reallocation of resources and the shutting down of spoke centers may have played a determinant role.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombectomy / Delivery of Health Care, Integrated / Stroke / Endovascular Procedures / Time-to-Treatment / COVID-19 Type of study: Diagnostic study / Observational study / Randomized controlled trials Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: J Stroke Cerebrovasc Dis Journal subject: Vascular Diseases / Brain Year: 2021 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombectomy / Delivery of Health Care, Integrated / Stroke / Endovascular Procedures / Time-to-Treatment / COVID-19 Type of study: Diagnostic study / Observational study / Randomized controlled trials Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: J Stroke Cerebrovasc Dis Journal subject: Vascular Diseases / Brain Year: 2021 Document Type: Article