Social Distancing, Stroke Admissions and Stroke Mortality During the COVID-19 Pandemic: A Multicenter, Longitudinal Study

Cougo, Pedro; Bessen, Bruno; Bezerra, Daniel C.; Moreira, Rodrigo de Carvalho; Brandão, Carlos Eduardo; Salgueiro, Emmanuel; Balduino, Alex; Pontes-Neto, Octávio M.; Cravo, Victor

doi:10.1016/j.jstrokecerebrovasdis.2022.106405

Cited by 4 publications

(7 citation statements)

References 29 publications

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“…Only one (25%) of four studies using indirect caseload metrics reported worse survival with surge (42). All three LMIC studies (14, 16, 27) and 29 of 35 studies (83%) from HICs reported worse survival with surge. eTables 6 and 7 (http://links.lww.com/CCM/H520) describe the spread of studies reporting detrimental outcomes throughout the pandemic quarters when analyzed by study end-date or publication months.…”

Section: Resultsmentioning

confidence: 96%

“…Most (19) were multicentric, 14 used nationwide data (one with 4626 hospitals) (22) and the remaining 6 were single-center studies (16,18,(23)(24)(25)(26). Thirty-five studies (90%) originated from HIC while only three (8%) were from LMIC (Brazil [27], Mexico [16], and South Africa [14]), and the remaining one was a global study (17) involving 280 ICUs from 46 countries (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 17 ICU studies, 14 studies reported on patients with COVID-19 and 3 on patients with other conditions (5, 27, 30). eTable 8 (http://links.lww.com/CCM/H520) provides detailed characteristics of these ICU studies.…”

Section: Resultsmentioning

confidence: 99%

“…Across the included 39 studies, there were 37 unique measures as shown in Tables 1 and 2. Of these, eleven (three from LMIC) tracked total hospital or ICU caseload unadjusted for baseline bed capacity (14,16,20,22,(25)(26)(27)(28)(29)(30)(31). Caseload was counted as either total census of all patients, total COVID-19-only patients, total positive or person under investigation, or only new admissions on the day of admission (30), daily (20,26,28), weekly (14,25), monthly (29), or quarterly (22).…”

Section: Measures Of Hospital Surge Strainmentioning

confidence: 99%

“…Only one (25%) of four studies using indirect caseload metrics reported worse survival with surge (42). All three LMIC studies (14,16,27) (5,27,30). eTable 8 (http://links.lww.com/ CCM/H520) provides detailed characteristics of these ICU studies.…”

Section: Surge-mortality Relationship Across Caseload-based Studiesmentioning

confidence: 99%

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Measures and Impact of Caseload Surge During the COVID-19 Pandemic: A Systematic Review*

Neupane,

De Jonge,

Angelo

et al. 2024

Critical Care Medicine

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Objectives: COVID-19 pandemic surges strained hospitals globally. We performed a systematic review to examine measures of pandemic caseload surge and its impact on mortality of hospitalized patients. Data Sources: PubMed, Embase, and Web of Science. Study Selection: English-language studies published between December 1, 2019, and November 22, 2023, which reported the association between pandemic “surge”-related measures and mortality in hospitalized patients. Data Extraction: Three authors independently screened studies, extracted data, and assessed individual study risk of bias. We assessed measures of surge qualitatively across included studies. Given multidomain heterogeneity, we semiquantitatively aggregated surge–mortality associations. Data Synthesis: Of 17,831 citations, we included 39 studies, 17 of which specifically described surge effects in ICU settings. The majority of studies were from high-income countries (n = 35 studies) and included patients with COVID-19 (n = 31). There were 37 different surge metrics which were mapped into four broad themes, incorporating caseloads either directly as unadjusted counts (n = 11), nested in occupancy (n = 14), including additional factors (e.g., resource needs, speed of occupancy; n = 10), or using indirect proxies (e.g., altered staffing ratios, alternative care settings; n = 4). Notwithstanding metric heterogeneity, 32 of 39 studies (82%) reported detrimental adjusted odds/hazard ratio for caseload surge–mortality outcomes, reporting point estimates of up to four-fold increased risk of mortality. This signal persisted among study subgroups categorized by publication year, patient types, clinical settings, and country income status. Conclusions: Pandemic caseload surge was associated with lower survival across most studies regardless of jurisdiction, timing, and population. Markedly variable surge strain measures precluded meta-analysis and findings have uncertain generalizability to lower-middle-income countries (LMICs). These findings underscore the need for establishing a consensus surge metric that is sensitive to capturing harms in everyday fluctuations and future pandemics and is scalable to LMICs.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Measures Of Hospital Surge Strainmentioning

confidence: 99%

Section: Surge-mortality Relationship Across Caseload-based Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Measures and Impact of Caseload Surge During the COVID-19 Pandemic: A Systematic Review*

Neupane,

De Jonge,

Angelo

et al. 2024

Critical Care Medicine

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Managing acute ischemic stroke in the SARS-CoV-2 pandemic

Budiansky,

Rajaleelan,

Chowdhury

2024

Management, Body Systems, and Case Studies in COVID-19

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Custo-efetividade da telemedicina no tratamento do acidente vascular cerebral isquêmico agudo na Irmandade da Santa Casa de Misericórdia de Matão-SP

Salvetti

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Agradeço à minha esposa, Maisa, e minha filha, Cecília, amores da minha vida que me fazem ser, gradativamente, uma pessoa melhor.Agradeço à Ana Cláudia Souza, sempre muito gentil e solícita, que tanto me ajudou com seus conhecimentos técnicos nesta pesquisa. Agradeço aoCésar Minelli, ao Diego Wagner Santos e a todos os profissionais do Hospital Carlos Fernando Malzoni (Santa Casa de Matão), em especial às diretorias executiva e administrativa, pelo acolhimento e suporte a esta pesquisa. Agradeço ao Prof. João Luiz Passador, pela sabedoria, ensinamentos, oportunidade e confiança a mim conferidos, desde os tempos de graduação. Agradeço ao Prof. Octávio Marques Pontes Neto, pelos ensinamentos, ideias e motivações, que deram início e sustentação a esta pesquisa. Agradeço ao Prof. Carlos Alberto Grespan Bonacim, pelos ensinamentos, pela humildade, pela simpatia e a disposição de ajudar. Agradeço ao Prof. Gilberto Prataviera, que me ensinou a gostar e admirar a estatística. Agradeço ao grupo do Centro de Estudos em Gestão e Políticas Públicas Contemporâneas (GPublic), por serem aguerridos defensores de uma gestão pública voltada ao desenvolvimento humano. O presente trabalho foi realizado com apoio da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior -Brasil (CAPES) -Código de Financiamento 001 (Portaria Nº 206, de 04/09/2018) "La lucidez es un don y es un castigo. Está todo en la palabra.Lúcido viene de Lucifer, el arcángel rebelde, el demonio. Pero también se llama Lucifer el lucero del alba, la primera estrella, la más brillante, la última en apagarse. Lúcido viene de Lucifer y Lucifer viene de Luz y de Fergus, que quiere decir el que tiene luz, el que genera, el que trae la luz que permite la visión interior: el bien y el mal, todo junto, el placer y el dolor. La lucidez es dolor y el único placer que uno puede conocer, lo único que se parecerá remotamente a la alegría será el placer de ser consciente de la propia lucidez. El silencio de la comprensión, el silencio del mero estar. En esto se van los años. En esto se fue la bella alegría animal."

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Social Distancing, Stroke Admissions and Stroke Mortality During the COVID-19 Pandemic: A Multicenter, Longitudinal Study

Cited by 4 publications

References 29 publications

Measures and Impact of Caseload Surge During the COVID-19 Pandemic: A Systematic Review*

Measures and Impact of Caseload Surge During the COVID-19 Pandemic: A Systematic Review*

Managing acute ischemic stroke in the SARS-CoV-2 pandemic

Custo-efetividade da telemedicina no tratamento do acidente vascular cerebral isquêmico agudo na Irmandade da Santa Casa de Misericórdia de Matão-SP

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