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Delays in Intracerebral Hemorrhage Management Is Associated with Hematoma Expansion and Worse Outcomes: Changes in COVID-19 Era.
Han, Hyun Jin; Park, Keun Young; Kim, Junhyung; Lee, Woosung; Lee, Yun Ho; Jang, Chang Ki; Cho, Kwang-Chun; Park, Sang Kyu; Chung, Joonho; Kwon, Young Sub; Kim, Yong Bae; Lee, Jae Whan; Kim, So Yeon.
  • Han HJ; Department of Neurosurgery, Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • Park KY; Department of Neurosurgery, Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • Kim J; Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • Lee W; Department of Neurosurgery, Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • Lee YH; Department of Neurosurgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
  • Jang CK; Department of Neurosurgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
  • Cho KC; Department of Neurosurgery, International St. Mary's Hospital, Catholic Kwandong University, Inchoen, Korea.
  • Park SK; Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • Chung J; Department of Neurosurgery, Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • Kwon YS; Department of Neurosurgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
  • Kim YB; Department of Neurosurgery, Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • Lee JW; Department of Neurosurgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
  • Kim SY; Department of Neurosurgery, International St. Mary's Hospital, Catholic Kwandong University, Inchoen, Korea. sallykimsy@gmail.com.
Yonsei Med J ; 62(10): 911-917, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1438409
ABSTRACT

PURPOSE:

The coronavirus disease 2019 (COVID-19) pandemic disrupted the emergency medical care system worldwide. We analyzed the changes in the management of intracerebral hemorrhage (ICH) and compared the pre-COVID-19 and COVID-19 eras. MATERIALS AND

METHODS:

From March to October of the COVID-19 era (2020), 83 consecutive patients with ICH were admitted to four comprehensive stroke centers. We retrospectively reviewed the data of patients and compared the treatment workflow metrics, treatment modalities, and clinical outcomes with the patients admitted during the same period of pre-COVID-19 era (2017-2019).

RESULTS:

Three hundred thirty-eight patients (83 in COVID-19 era and 255 in pre-COVID-19 era) were included in this study. Symptom onset/detection-to-door time [COVID-19; 56.0 min (34.0-106.0), pre-COVID-19; 40.0 min (27.0-98.0), p=0.016] and median door to-intensive treatment time differed between the two groups [COVID-19; 349.0 min (177.0-560.0), pre-COVID-19; 184.0 min (134.0-271.0), p<0.001]. Hematoma expansion was detected more significantly in the COVID-19 era (39.8% vs. 22.1%, p=0.002). At 3-month follow-up, clinical outcomes of patients were worse in the COVID-19 era (Good modified Rankin Scale; 33.7% in COVID19, 46.7% in pre-COVID-19, p=0.039).

CONCLUSION:

During the COVID-19 era, delays in management of ICH was associated with hematoma expansion and worse outcomes.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Yonsei Med J Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Yonsei Med J Year: 2021 Document Type: Article