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The stroke mothership model survived during COVID-19 era: an observational single-center study in Emilia-Romagna, Italy.
Zini, Andrea; Romoli, Michele; Gentile, Mauro; Migliaccio, Ludovica; Picoco, Cosimo; Dell'Arciprete, Oscar; Simonetti, Luigi; Naldi, Federica; Piccolo, Laura; Gordini, Giovanni; Tagliatela, Francesco; Bua, Vincenzo; Cirillo, Luigi; Princiotta, Ciro; Coniglio, Carlo; Descovich, Carlo; Cortelli, Pietro.
  • Zini A; IRCCS Istituto delle Scienze Neurologiche di Bologna, Department of Neurology and Metropolitan Stroke Center, "C.A. Pizzardi" Maggiore Hospital, Largo Nigrisoli 2, 40133, Bologna, Italy.
  • Romoli M; IRCCS Istituto delle Scienze Neurologiche di Bologna, Department of Neurology and Metropolitan Stroke Center, "C.A. Pizzardi" Maggiore Hospital, Largo Nigrisoli 2, 40133, Bologna, Italy. michele.romoli@studenti.unipg.it.
  • Gentile M; Neurology Clinic, University of Perugia, Perugia, Italy. michele.romoli@studenti.unipg.it.
  • Migliaccio L; IRCCS Istituto delle Scienze Neurologiche di Bologna, Department of Neurology and Metropolitan Stroke Center, "C.A. Pizzardi" Maggiore Hospital, Largo Nigrisoli 2, 40133, Bologna, Italy.
  • Picoco C; IRCCS Istituto delle Scienze Neurologiche di Bologna, Department of Neurology and Metropolitan Stroke Center, "C.A. Pizzardi" Maggiore Hospital, Largo Nigrisoli 2, 40133, Bologna, Italy.
  • Dell'Arciprete O; Department of Anaesthesia, Intensive Care and Emergency Medical Services, Maggiore Hospital, Bologna, Italy.
  • Simonetti L; Department of Anaesthesia, Intensive Care and Emergency Medical Services, Maggiore Hospital, Bologna, Italy.
  • Naldi F; Neuroradiology Unit, Maggiore Hospital, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
  • Piccolo L; IRCCS Istituto delle Scienze Neurologiche di Bologna, Department of Neurology and Metropolitan Stroke Center, "C.A. Pizzardi" Maggiore Hospital, Largo Nigrisoli 2, 40133, Bologna, Italy.
  • Gordini G; IRCCS Istituto delle Scienze Neurologiche di Bologna, Department of Neurology and Metropolitan Stroke Center, "C.A. Pizzardi" Maggiore Hospital, Largo Nigrisoli 2, 40133, Bologna, Italy.
  • Tagliatela F; Department of Anaesthesia, Intensive Care and Emergency Medical Services, Maggiore Hospital, Bologna, Italy.
  • Bua V; Neuroradiology Unit, Maggiore Hospital, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
  • Cirillo L; Department of Anaesthesia, Intensive Care and Emergency Medical Services, Maggiore Hospital, Bologna, Italy.
  • Princiotta C; Neuroradiology Unit, Bellaria Hospital, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
  • Coniglio C; DIMES, Department of Specialty, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy.
  • Descovich C; Neuroradiology Unit, Bellaria Hospital, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
  • Cortelli P; Department of Anaesthesia, Intensive Care and Emergency Medical Services, Maggiore Hospital, Bologna, Italy.
Neurol Sci ; 41(12): 3395-3399, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-841441
Semantic information from SemMedBD (by NLM)
1. Cerebrovascular accident PROCESS_OF Social Networks
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Social Networks
2. Ischemic stroke PROCESS_OF Patients
Subject
Ischemic stroke
Predicate
PROCESS_OF
Object
Patients
3. COVID-19 AFFECTS Social Networks
Subject
COVID-19
Predicate
AFFECTS
Object
Social Networks
4. Stroke Center LOCATION_OF Retrospective Studies
Subject
Stroke Center
Predicate
LOCATION_OF
Object
Retrospective Studies
5. Cerebrovascular accident PROCESS_OF Social Networks
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Social Networks
6. Ischemic stroke PROCESS_OF Patients
Subject
Ischemic stroke
Predicate
PROCESS_OF
Object
Patients
7. COVID-19 AFFECTS Social Networks
Subject
COVID-19
Predicate
AFFECTS
Object
Social Networks
8. Stroke Center LOCATION_OF Retrospective Studies
Subject
Stroke Center
Predicate
LOCATION_OF
Object
Retrospective Studies
ABSTRACT

INTRODUCTION:

A reduction of the hospitalization and reperfusion treatments was reported during COVID-19 pandemic. However, high variability in results emerged, potentially due to logistic paradigms adopted. Here, we analyze stroke code admissions, hospitalizations, and stroke belt performance for ischemic stroke patients in the metropolitan Bologna region, comparing temporal trends between 2019 and 2020 to define the impact of COVID-19 on the stroke network.

METHODS:

This retrospective observational study included all people admitted at the Bologna Metropolitan Stroke Center in timeframes 1 March 2019-30 April 2019 (cohort-2019) and 1 March 2020-30 April 2020 (cohort-2020). Diagnosis, treatment strategy, and timing were compared between the two cohorts to define temporal trends.

RESULTS:

Overall, 283 patients were admitted to the Stroke Center, with no differences in demographic factors between cohort-2019 and cohort-2020. In cohort-2020, transient ischemic attack (TIA) was significantly less prevalent than 2019 (6.9% vs 14.4%, p = .04). Among 216 ischemic stroke patients, moderate-to-severe stroke was more represented in cohort-2020 (17.8% vs 6.2%, p = .027). Similar proportions of patients underwent reperfusion (45.9% in 2019 vs 53.4% in 2020), although a slight increase in combined treatment was detected (14.4% vs 25.4%, p = .05). Door-to-scan timing was significantly prolonged in 2020 compared with 2019 (28.4 ± 12.6 vs 36.7 ± 14.6, p = .03), although overall timing from stroke to treatment was preserved.

CONCLUSION:

During COVID-19 pandemic, TIA and minor stroke consistently reduced compared to the same timeframe in 2019. Longer stroke-to-call and door-to-scan times, attributable to change in citizen behavior and screening at hospital arrival, did not impact on stroke-to-treatment time. Mothership model might have minimized the effects of the pandemic on the stroke care organization.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Stroke / Pandemics / Neurology Type of study: Observational study / Prevalence study / Prognostic study / Risk factors Limits: Humans Country/Region as subject: Europa Language: English Journal: Neurol Sci Journal subject: Neurology Year: 2020 Document Type: Article Affiliation country: S10072-020-04754-2

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Stroke / Pandemics / Neurology Type of study: Observational study / Prevalence study / Prognostic study / Risk factors Limits: Humans Country/Region as subject: Europa Language: English Journal: Neurol Sci Journal subject: Neurology Year: 2020 Document Type: Article Affiliation country: S10072-020-04754-2