Implementing the SNIS recommendations for neurointerventional emergent care in the setting of COVID-19: impact on stroke metrics and patient outcomes

التفاصيل البيبلوغرافية
العنوان: Implementing the SNIS recommendations for neurointerventional emergent care in the setting of COVID-19: impact on stroke metrics and patient outcomes
المؤلفون: Amy Nieberlein, Kathryn McCarthy, Benjamin Atchie, Christian Burrell, Erica Stoddard, Alicia Bennett, Donald Frei, Russell Bartt, Kristin Salottolo, David Bar-Or, Stephanie Jarvis
المصدر: Journal of Neurointerventional Surgery
سنة النشر: 2021
مصطلحات موضوعية: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Emergent care, Treatment use, Time-to-Treatment, Medicine, Humans, Thrombolytic Therapy, Stroke, Pandemics, Retrospective Studies, Ischemic Stroke, Groin, business.industry, SARS-CoV-2, COVID-19, Retrospective cohort study, General Medicine, medicine.disease, stroke, Benchmarking, medicine.anatomical_structure, Treatment utilization, Treatment Outcome, thrombectomy, Emergency medicine, Ischemic stroke, standards, Surgery, Neurology (clinical), business
الوصف: BackgroundIt is not clear whether the COVID-19 pandemic and subsequent Society of Neurointerventional Surgery (SNIS) recommendations affected hospital stroke metrics.MethodsThis retrospective cohort study compared stroke patients admitted to a comprehensive stroke center during the COVID-19 pandemic April 1 2020 to June 30 2020 (COVID-19) to patients admitted April 1 2019 to June 30 2019. We examined stroke admission volume and acute stroke treatment use.ResultsThere were 637 stroke admissions, 52% in 2019 and 48% during COVID-19, with similar median admissions per day (4 vs 3, P=0.21). The proportion of admissions by stroke type was comparable (ischemic, P=0.69; hemorrhagic, P=0.39; transient ischemic stroke, P=0.10). Acute stroke treatment was similar in 2019 to COVID-19: tPA prior to arrival (18% vs, 18%, P=0.89), tPA treatment on arrival (6% vs 7%, P=0.85), and endovascular therapy (endovascular therapy (ET), 22% vs 25%, P=0.54). The door to needle time was also similar, P=0.12, however, the median time from arrival to groin puncture was significantly longer during COVID-19 (38 vs 43 min, P=0.002). A significantly higher proportion of patients receiving ET were intubated during COVID-19 due to SNIS guideline implementation (45% vs 96%, PConclusionsThe COVID-19 pandemic did not significantly affect stroke admission volume or acute stroke treatment utilization. Outcomes were not affected by implementing SNIS guidelines. Although there was a statistical increase in time to groin puncture for ET, it was not clinically meaningful. These results suggest hospitals managing patients efficiently can implement practices in response to COVID-19 without impacting outcomes.
تدمد: 1759-8486
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ae4ca032a18c67727b972e5958a3c884
https://pubmed.ncbi.nlm.nih.gov/33758066
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....ae4ca032a18c67727b972e5958a3c884
قاعدة البيانات: OpenAIRE