Impact of the SARS-COV-2 Pandemic on the Endovascular Treatment of Acute Stroke - an Italian Single-Center Experience.
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 ANDMETHODS:
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.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
/
Experimental Studies
/
Observational study
/
Prognostic 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
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