QUALITY OF ACUTE STROKE CARE AND OUTCOMES: THE FIRST TWO WAVES OF THE COVID-19 PANDEMIC IN THE UNITED KINGDOM
European Stroke Journal
; 7(1 SUPPL):21-22, 2022.
Article
in English
| EMBASE | ID: covidwho-1928117
ABSTRACT
Background:
The COVID-19 pandemic has been reported as affecting the quality and outcomes of stroke care around the world. The impact of the first and second waves of the pandemic in the UK are compared.Methods:
Data were extracted from the Sentinel Stroke National Audit Programme database of stroke admissions in England, Wales and Northern Ireland. Care quality and outcomes for 72,698 patients admitted during the first (1 March - 30 June 2020) and second (27 September 2020 - 31 March 2021) pandemic waves were compared.Results:
From the first to second wave, there was an increase in mild strokes admitted (40.3% to 41.3%;p=0.002) and median NIHSS on arrival decreased (5 vs 4, p<0.001). The second wave was characterised by a decrease in direct stroke unit admission (79.8% to 76.6% ;p<0.001). Time to initial assessment by all specialists increased. Time to stroke consultant assessment increased by 34 minutes (262 vs 296 minutes;p<0.001). Complications (pneumonia 8.6% to 9.4%, UTI 3.3% to 3.9%;both p < 0.001) and in-hospital mortality (10.6% to 12.4%;p<0.001) increased significantly. Moderate and moderately-severe disability were more prevalent at discharge (18.1 to 18.6%, 18.3% to 19.9% respectively;p<0.001). Early supported discharge increased from 39.1% to 44.5% (p>0.001).Conclusions:
Hospital avoidance by patients with mild stroke seen in the first wave was not replicated in the second wave. COVID-19 pressures on hospitals in the second wave appeared to result in fewer direct stroke unit admissions, delays in acute assessment, more complications, and more in-hospital deaths. (Figure Presented).
adult; avoidance behavior; cerebrovascular accident; complication; conference abstract; consultation; controlled study; coronavirus disease 2019; disability; England; female; human; in-hospital mortality; major clinical study; male; National Institutes of Health Stroke Scale; Northern Ireland; outcome assessment; pandemic; pneumonia; stroke unit; United Kingdom; Wales
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
European Stroke Journal
Year:
2022
Document Type:
Article
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