Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Stroke+Cerebrovasc+Dis 2020 ; 29 (9): 105068 Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
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 PMID32807471show 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.
free
free
free
J+Stroke+Cerebrovasc+Dis 2020 ; 29 (9): 105068
