Impact of the COVID-19 pandemic on hyperacute stroke treatment: experience from a comprehensive stroke centre in Singapore.
Aged
COVID-19
Comprehensive Health Care
/ organization & administration
Coronavirus Infections
/ diagnosis
Delivery of Health Care, Integrated
/ organization & administration
Emergency Service, Hospital
/ organization & administration
Female
Health Services Needs and Demand
/ organization & administration
Humans
Male
Middle Aged
Pandemics
Patient Care Team
/ organization & administration
Pneumonia, Viral
/ diagnosis
Recovery of Function
Referral and Consultation
/ organization & administration
Singapore
/ epidemiology
Stroke
/ diagnosis
Time Factors
Time-to-Treatment
/ organization & administration
Treatment Outcome
Workflow
Acute ischaemic stroke
COVID-19
Recanalization therapy
Stroke activation
Journal
Journal of thrombosis and thrombolysis
ISSN: 1573-742X
Titre abrégé: J Thromb Thrombolysis
Pays: Netherlands
ID NLM: 9502018
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
pubmed:
15
7
2020
medline:
2
10
2020
entrez:
15
7
2020
Statut:
ppublish
Résumé
The Coronavirus disease 2019 (COVID-19) pandemic is rapidly evolving and affecting healthcare systems across the world. Singapore has escalated its alert level to Disease Outbreak Response System Condition (DORSCON) Orange, signifying severe disease with community spread. We aimed to study the overall volume of AIS cases and the delivery of hyperacute stroke services during DORSCON Orange. This was a single-centre, observational cohort study performed at a comprehensive stroke centre responsible for AIS cases in the western region of Singapore, as well as providing care for COVID-19 patients. All AIS patients reviewed as an acute stroke activation in the Emergency Department (ED) from November 2019 to April 2020 were included. System processes timings, treatment and clinical outcome variables were collected. We studied 350 AIS activation patients admitted through the ED, 206 (58.9%) pre- and 144 during DORSCON Orange. Across the study period, number of stroke activations showed significant decline (p = 0.004, 95% CI 6.513 to - 2.287), as the number of COVID-19 cases increased exponentially, whilst proportion of activations receiving acute recanalization therapy remained stable (p = 0.519, 95% CI - 1.605 to 2.702). Amongst AIS patients that received acute recanalization therapy, early neurological outcomes in terms of change in median NIHSS at 24 h (-4 versus -4, p = 0.685) were largely similar between the pre- and during DORSCON orange periods. The number of stroke activations decreased while the proportion receiving acute recanalization therapy remained stable in the current COVID-19 pandemic in Singapore.
Identifiants
pubmed: 32661758
doi: 10.1007/s11239-020-02225-1
pii: 10.1007/s11239-020-02225-1
pmc: PMC7358288
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
596-603Références
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