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10.1016/j.jstrokecerebrovasdis.2020.105068 http://scihub22266oqcxt.onion/10.1016/j.jstrokecerebrovasdis.2020.105068 C7305900!7305900 !32807471     free     free     free Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\32807471 .jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117       J+Stroke+Cerebrovasc+Dis 2020 ; 29 (9 ): 105068 Nephropedia Template TP {{tp|p=32807471 |t=2020. Acute stroke care in a New York City comprehensive stroke center during the COVID-19 pandemic |pdf=|usr=}}{{32807471 }} gab.com Text Acute stroke care in a New York City comprehensive stroke center during the COVID-19 pandemic JO: J Stroke Cerebrovasc Dis http://www.kidney.de/pget.php?&tw=1&pmid=32807471 #FOAvip BACKGROUND AND PURPOSE: The coronavirus disease-2019 (COVID-19) pandemic caused unprecedented demand and burden on emergency health care services in New York City. We aim to describe our experience providing acute stroke care at a comprehensive stroke center (CSC) and the impact of the pandemic on the quality of care for patients presenting with acute ischemic stroke (AIS). METHODS: We retrospectively analyzed data from a quality improvement registry of consecutive AIS patients at New York University Langone Health's CSC between 06/01/2019-05/15/2020. During the early stages of the pandemic, the acute stroke process was modified to incorporate COVID-19 screening, testing, and other precautionary measures. We compared stroke quality metrics including treatment times and discharge outcomes of AIS patients during the pandemic (03/012020-05/152020) compared with a historical pre-pandemic group (6/1/2019-2/29/2020). RESULTS: A total of 754 patients (pandemic-120; pre-pandemic-634) were admitted with a principal diagnosis of AIS; 198 (26.3%) received alteplase and/or mechanical thrombectomy. Despite longer median door to head CT times (16 vs 12 minutes; p = 0.05) and a trend towards longer door to groin puncture times (79.5 vs. 71 min, p?=?0.06), the time to alteplase administration (36 vs 35 min; p?=?0.83), door to reperfusion times (103 vs 97 min, p?=?0.18) and defect-free care (95.2% vs 94.7%; p?=?0.84) were similar in the pandemic and pre-pandemic groups. Successful recanalization rates (TICI?2b) were also similar (82.6% vs. 86.7%, p?=?0.48). After adjusting for stroke severity, age and a prior history of transient ischemic attack/stroke, pandemic patients had increased discharge mortality (adjusted OR 2.90 95% CI 1.77 - 7.17, p?=?0.021) CONCLUSION: Despite unprecedented demands on emergency healthcare services, early multidisciplinary efforts to adapt the acute stroke treatment process resulted in keeping the stroke quality time metrics close to pre-pandemic levels. Future studies will be needed with a larger cohort comparing discharge and long-term outcomes between pre-pandemic and pandemic AIS patients. Twit Text FOAVip Acute stroke care in a New York City comprehensive stroke center during the COVID-19 pandemic ????J Stroke Cerebrovasc Dis http://www.kidney.de/pget.php?&tw=1&pmid=32807471 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=32807471 #FOAvip English Wikipedia <ref>{{Cite pmid|32807471 }}</ref> Acute stroke care in a New York City comprehensive stroke center during the COVID-19 pandemic #MMPMID32807471 Agarwal S ; Scher E ; Rossan-Raghunath N ; Marolia D ; Butnar M ; Torres J ; Zhang C ; Kim S ; Sanger M ; Humbert K ; Tanweer O ; Shapiro M ; Raz E ; Nossek E ; Nelson PK ; Riina HA ; de Havenon A ; Wachs M ; Farkas J ; Tiwari A ; Arcot K ; Parella DT ; Liff J ; Wu T ; Wittman I ; Caldwell R ; Frontera J ; Lord A ; Ishida K ; Yaghi S J Stroke Cerebrovasc Dis 2020[Sep]; 29 (9 ): 105068 PMID32807471 show ga BACKGROUND AND PURPOSE: The coronavirus disease-2019 (COVID-19) pandemic caused unprecedented demand and burden on emergency health care services in New York City. We aim to describe our experience providing acute stroke care at a comprehensive stroke center (CSC) and the impact of the pandemic on the quality of care for patients presenting with acute ischemic stroke (AIS). METHODS: We retrospectively analyzed data from a quality improvement registry of consecutive AIS patients at New York University Langone Health's CSC between 06/01/2019-05/15/2020. During the early stages of the pandemic, the acute stroke process was modified to incorporate COVID-19 screening, testing, and other precautionary measures. We compared stroke quality metrics including treatment times and discharge outcomes of AIS patients during the pandemic (03/012020-05/152020) compared with a historical pre-pandemic group (6/1/2019-2/29/2020). RESULTS: A total of 754 patients (pandemic-120; pre-pandemic-634) were admitted with a principal diagnosis of AIS; 198 (26.3%) received alteplase and/or mechanical thrombectomy. Despite longer median door to head CT times (16 vs 12 minutes; p = 0.05) and a trend towards longer door to groin puncture times (79.5 vs. 71 min, p?=?0.06), the time to alteplase administration (36 vs 35 min; p?=?0.83), door to reperfusion times (103 vs 97 min, p?=?0.18) and defect-free care (95.2% vs 94.7%; p?=?0.84) were similar in the pandemic and pre-pandemic groups. Successful recanalization rates (TICI?2b) were also similar (82.6% vs. 86.7%, p?=?0.48). After adjusting for stroke severity, age and a prior history of transient ischemic attack/stroke, pandemic patients had increased discharge mortality (adjusted OR 2.90 95% CI 1.77 - 7.17, p?=?0.021) CONCLUSION: Despite unprecedented demands on emergency healthcare services, early multidisciplinary efforts to adapt the acute stroke treatment process resulted in keeping the stroke quality time metrics close to pre-pandemic levels. Future studies will be needed with a larger cohort comparing discharge and long-term outcomes between pre-pandemic and pandemic AIS patients. |*Thrombectomy [MESH] |*Thrombolytic Therapy [MESH] |Aged [MESH] |Aged, 80 and over [MESH] |Betacoronavirus/*pathogenicity [MESH] |COVID-19 [MESH] |Comprehensive Health Care/*organization & administration [MESH] |Coronavirus Infections/diagnosis/epidemiology/*therapy/virology [MESH] |Critical Pathways/organization & administration [MESH] |Delivery of Health Care, Integrated/*organization & administration [MESH] |Female [MESH] |Humans [MESH] |Male [MESH] |Middle Aged [MESH] |New York City/epidemiology [MESH] |Pandemics [MESH] |Patient Care Team/organization & administration [MESH] |Pneumonia, Viral/diagnosis/epidemiology/*therapy/virology [MESH] |Quality Improvement/*organization & administration [MESH] |Quality Indicators, Health Care/*organization & administration [MESH] |Registries [MESH] |Retrospective Studies [MESH] |SARS-CoV-2 [MESH] |Stroke/diagnosis/epidemiology/*therapy [MESH] |Time Factors [MESH] |Time-to-Treatment/organization & administration [MESH] |Treatment Outcome [MESH]Acute stroke care in a New York City comprehensive stroke center durin(epmc).pdf DeepDyve Pubget Overpricing