Impact of COVID-19 pandemic on acute stroke care-data analysis from the RES-Q registry 2020 in N. Macedonia

Arsovska, Anita; Mikulík, Robert; Bornstein, Natan

doi:10.1016/j.jns.2021.119866

Cited by 1 publication

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“…Although a few groups report large prolongations, mainly driven by the hospital saturation delaying the diagnostic and therapeutic processes [ 33 , 39 ], most report decreases (which may be explained by the need to ensure available beds to attend more patients coming from the emergency departments) or no differences [ 40 – 43 ]. In our study we found a slight increase in length of stay (near 3 hours), although we did not conduct an analysis on the specific reasons for this mild increase.…”

Section: Discussionmentioning

confidence: 99%

The COVID-19 pandemic effect on the prehospital Madrid stroke code metrics and diagnostic accuracy

Riera-López

Gaetano-Gil²,

Martínez-Gómez³

et al. 2022

PLoS ONE

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Background Only very few studies have investigated the effect of the COVID-19 pandemic on the pre-hospital stroke code protocol. During the first wave, Spain was one of the most affected countries by the SARS-CoV-2 coronavirus disease pandemic. This health catastrophe overshadowed other pathologies, such as acute stroke, the leading cause of death among women and the leading cause of disability among adults. Any interference in the stroke code protocol can delay the administration of reperfusion treatment for acute ischemic strokes, leading to a worse patient prognosis. We aimed to compare the performance of the stroke code during the first wave of the pandemic with the same period of the previous year. Methods This was a multicentre interrupted time-series observational study of the cohort of stroke codes of SUMMA 112 and of the ten hospitals with a stroke unit in the Community of Madrid. We established two groups according to the date on which they were attended: the first during the dates with the highest daily cumulative incidence of the first wave of the COVID-19 (from February 27 to June 15, 2020), and the second, the same period of the previous year (from February 27 to June 15, 2019). To assess the performance of the stroke code, we compared each of the pre-hospital emergency service time periods, the diagnostic accuracy (proportion of stroke codes with a final diagnosis of acute stroke out of the total), the proportion of patients treated with reperfusion therapies, and the in-hospital mortality. Results SUMMA 112 activated the stroke code in 966 patients (514 in the pre-pandemic group and 452 pandemic). The call management time increased by 9% (95% CI: -0.11; 0.91; p value = 0.02), and the time on scene increased by 12% (95% CI: 2.49; 5.93; p value = <0.01). Diagnostic accuracy, and the proportion of patients treated with reperfusion therapies remained stable. In-hospital mortality decreased by 4% (p = 0.05). Conclusions During the first wave, a prolongation of the time “on the scene” of the management of the 112 calls, and of the hospital admission was observed. Prehospital diagnostic accuracy and the proportion of patients treated at the hospital level with intravenous thrombolysis or mechanical thrombectomy were not altered with respect to the previous year, showing the resilience of the stroke network and the emergency medical service.

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