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Delayed presentation of acute ischemic strokes during the COVID-19 crisis.
Schirmer, Clemens M; Ringer, Andrew J; Arthur, Adam S; Binning, Mandy J; Fox, W Christopher; James, Robert F; Levitt, Michael R; Tawk, Rabih G; Veznedaroglu, Erol; Walker, Melanie; Spiotta, Alejandro M.
  • Schirmer CM; Department of Neurosurgery and Neuroscience Institute, Geisinger Health System, Wilkes-Barre, PA, United States cmschirmer@gmail.com.
  • Ringer AJ; Department of Neurosurgery, Geisinger Commonwealth School of Medicine, Scranton, PA, United States.
  • Arthur AS; Research Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.
  • Binning MJ; Mayfield Clinic, Cincinnati, OH, United States.
  • Fox WC; Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA.
  • James RF; Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
  • Levitt MR; Global Neurosciences Institute, Pennington, NJ, United States.
  • Tawk RG; Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, United States.
  • Veznedaroglu E; Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, United States.
  • Walker M; Neurological Surgery, Radiology and Mechanical Engineering, University of Washington, Seattle, Washington, USA.
  • Spiotta AM; Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, United States.
J Neurointerv Surg ; 12(7): 639-642, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-432969
Semantic information from SemMedBD (by NLM)
1. Acute Cerebrovascular Accidents COEXISTS_WITH Crisis
Subject
Acute Cerebrovascular Accidents
Predicate
COEXISTS_WITH
Object
Crisis
2. Awareness PROCESS_OF Patients
Subject
Awareness
Predicate
PROCESS_OF
Object
Patients
3. Acute Cerebrovascular Accidents PROCESS_OF Patients
Subject
Acute Cerebrovascular Accidents
Predicate
PROCESS_OF
Object
Patients
4. Acute Cerebrovascular Accidents COEXISTS_WITH Crisis
Subject
Acute Cerebrovascular Accidents
Predicate
COEXISTS_WITH
Object
Crisis
5. Awareness PROCESS_OF Patients
Subject
Awareness
Predicate
PROCESS_OF
Object
Patients
6. Acute Cerebrovascular Accidents PROCESS_OF Patients
Subject
Acute Cerebrovascular Accidents
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

BACKGROUND:

The COVID-19 pandemic has disrupted established care paths worldwide. Patient awareness of the pandemic and executive limitations imposed on public life have changed the perception of when to seek care for acute conditions in some cases. We sought to study whether there is a delay in presentation for acute ischemic stroke patients in the first month of the pandemic in the US.

METHODS:

The interval between last-known-well (LKW) time and presentation of 710 consecutive patients presenting with acute ischemic strokes to 12 stroke centers across the US were extracted from a prospectively maintained quality database. We analyzed the timing and severity of the presentation in the baseline period from February to March 2019 and compared results with the timeframe of February and March 2020.

RESULTS:

There were 320 patients in the 2-month baseline period in 2019, there was a marked decrease in patients from February to March of 2020 (227 patients in February, and 163 patients in March). There was no difference in the severity of the presentation between groups and no difference in age between the baseline and the COVID period. The mean interval from LKW to the presentation was significantly longer in the COVID period (603±1035 min) compared with the baseline period (442±435 min, P<0.02).

CONCLUSION:

We present data supporting an association between public awareness and limitations imposed on public life during the COVID-19 pandemic in the US and a delay in presentation for acute ischemic stroke patients to a stroke center.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Brain Ischemia / Coronavirus Infections / Stroke / Delayed Diagnosis / Betacoronavirus Type of study: Controlled clinical trial / Diagnostic study / Clinical Practice Guide / Observational study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: J Neurointerv Surg Year: 2020 Document Type: Article Affiliation country: Neurintsurg-2020-016299

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Brain Ischemia / Coronavirus Infections / Stroke / Delayed Diagnosis / Betacoronavirus Type of study: Controlled clinical trial / Diagnostic study / Clinical Practice Guide / Observational study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: J Neurointerv Surg Year: 2020 Document Type: Article Affiliation country: Neurintsurg-2020-016299