Abstract P277: The Impact of Implementing the SNIS Recommendations for the Care of Emergent Neurointerventional Patients in the Setting of COVID-19 on Patients Undergoing Mechanical Thrombectomy
| العنوان: | Abstract P277: The Impact of Implementing the SNIS Recommendations for the Care of Emergent Neurointerventional Patients in the Setting of COVID-19 on Patients Undergoing Mechanical Thrombectomy |
|---|---|
| المؤلفون: | Kathryn McCarthy, Benjamin Atchie, Kristin Salottolo, Russell Bartt, David Bar-Or, Alicia Bennett, Stephanie Jarvis, Christian J Burrell, Amy Nieberlein |
| المصدر: | Stroke. 52 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Advanced and Specialized Nursing, Coronavirus disease 2019 (COVID-19), Groin, business.industry, medicine.medical_treatment, Retrospective cohort study, Thrombolysis, Mechanical thrombectomy, Exact test, medicine.anatomical_structure, Anesthesia, Ischemic stroke, medicine, Intubation, Neurology (clinical), Cardiology and Cardiovascular Medicine, business |
| الوصف: | Introduction: As a result of the novel coronavirus 2019 (COVID-19) pandemic, the Society for Neurointerventional Surgery (SNIS) issued guidelines for patient management during COVID-19. Specifically, they suggested intubating COVID-19 positive or those with unknown COVID-19 status prior to emergent endovascular thrombectomy, cohorting by COVID-19 status, early ICU discharge, and postponing elective cases. We sought to determine how the implementation of SNIS guidelines affected outcomes for patients with ischemic stroke. Methods: This was a retrospective cohort study comparing ischemic stroke patients who were treated with thrombectomy admitted during the COVID-19 pandemic 4/1/20-6/30/20 “COVID-19 peak” to patients admitted 4/1/19-6/30/19 “2019”. Statistical tests used for analysis included Kruskal-Wallis, chi-squared and Fisher’s exact test. Results: The proportion of patients treated with thrombectomy was not significantly different, 23% in 2019 vs. 24% during the COVID-19 peak, p=0.67. There were 112 patients treated with thrombectomy: 57 (51%) in 2019, 55 (49%) during the COVID-19 peak. No patients treated with thrombectomy were positive for COVID-19, but 27 (49%) were tested. The median age was 69 for those treated in 2019 and 69 for those during the COVID-19 peak, p=0.44. Patients were similar in sex, race, and comorbidities. The time from onset to arrival was also statistically similar, p=0.19. In 2019, 16% received tPA compared to 9% during the COVID-19 peak, p=0.28. The median time to groin puncture was significantly shorter in 2019, 38 minutes, than during the COVID-19 peak, 44 minutes, p=0.01. The recanalization rate and mRS were similar between groups, p=0.06, and p=0.91, respectively. Conclusions: After implementing the SNIS guidelines, including pre-treatment intubation, we observed a significantly longer time to groin puncture. Anecdotally, the increased observed was remarkably small given the changes to care and did not negatively impact patient outcomes. This suggests that hospitals managing patients efficiently can implement changes in response to COVID-19 and continue high level of care without impacting outcomes. Therefore, we recommend following the SNIS guidelines to prevent the spread of COVID-19. |
| تدمد: | 1524-4628 0039-2499 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::1cb48a7af3a7fb06eeebb8a3fea14422 https://doi.org/10.1161/str.52.suppl_1.p277 |
| رقم الأكسشن: | edsair.doi...........1cb48a7af3a7fb06eeebb8a3fea14422 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15244628 00392499 |
|---|