The Impact of COVID-19 on Emergent Large-Vessel Occlusion: Delayed Presentation Confirmed by ASPECTS.
Journal
AJNR. American journal of neuroradiology
ISSN: 1936-959X
Titre abrégé: AJNR Am J Neuroradiol
Pays: United States
ID NLM: 8003708
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
02
07
2020
accepted:
27
07
2020
pubmed:
5
9
2020
medline:
29
12
2020
entrez:
5
9
2020
Statut:
ppublish
Résumé
Our hypothesis is that the COVID-19 pandemic led to delayed presentations for patients with acute ischemic stroke. This study evaluates the impact of the coronavirus disease 2019 pandemic on presentation, treatment, and outcomes of patients with emergent large-vessel occlusion using data from a large health system in the Bronx, New York. We performed a retrospective cohort study of 2 cohorts of consecutive patients with emergent large-vessel occlusion admitted to 3 Montefiore Health System hospitals in the Bronx from January 1 to February 17, 2020, (prepandemic) and March 1 to April 17, 2020 (pandemic). We abstracted data from the electronic health records on presenting biomarker profiles, admission and postprocedural NIHSS scores, time of symptom onset, time of hospital presentation, time of start of the thrombectomy procedure, time of revascularization, presenting ASPECTS, TICI recanalization score, mRS, functional outcomes, and mortality. Of 179 patients admitted with ischemic stroke during the study periods, 80 had emergent large-vessel occlusion, of whom 36 were in the pandemic group. Patients in the pandemic group were younger (66 versus 72 years, The pandemic led to delays in patients arriving at hospitals, leading to decreased patients eligible for treatment, while in-hospital evaluation and treatment times remain unchanged.
Sections du résumé
BACKGROUND AND PURPOSE
Our hypothesis is that the COVID-19 pandemic led to delayed presentations for patients with acute ischemic stroke. This study evaluates the impact of the coronavirus disease 2019 pandemic on presentation, treatment, and outcomes of patients with emergent large-vessel occlusion using data from a large health system in the Bronx, New York.
MATERIALS AND METHODS
We performed a retrospective cohort study of 2 cohorts of consecutive patients with emergent large-vessel occlusion admitted to 3 Montefiore Health System hospitals in the Bronx from January 1 to February 17, 2020, (prepandemic) and March 1 to April 17, 2020 (pandemic). We abstracted data from the electronic health records on presenting biomarker profiles, admission and postprocedural NIHSS scores, time of symptom onset, time of hospital presentation, time of start of the thrombectomy procedure, time of revascularization, presenting ASPECTS, TICI recanalization score, mRS, functional outcomes, and mortality.
RESULTS
Of 179 patients admitted with ischemic stroke during the study periods, 80 had emergent large-vessel occlusion, of whom 36 were in the pandemic group. Patients in the pandemic group were younger (66 versus 72 years,
CONCLUSIONS
The pandemic led to delays in patients arriving at hospitals, leading to decreased patients eligible for treatment, while in-hospital evaluation and treatment times remain unchanged.
Identifiants
pubmed: 32883669
pii: ajnr.A6800
doi: 10.3174/ajnr.A6800
pmc: PMC7963250
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2271-2273Informations de copyright
© 2020 by American Journal of Neuroradiology.
Références
J Neurointerv Surg. 2020 Jul;12(7):648-653
pubmed: 32451359
JAMA Neurol. 2017 Jul 1;74(7):793-800
pubmed: 28492918
Stroke. 2020 Jul;51(7):2228-2231
pubmed: 32432998
Stroke. 2020 Jul;51(7):2002-2011
pubmed: 32432996
Stroke. 2020 Jul;51(7):2219-2223
pubmed: 32466735
J Neurointerv Surg. 2020 Jul;12(7):639-642
pubmed: 32467244
N Engl J Med. 2020 Jul 23;383(4):400-401
pubmed: 32383831
Stroke. 2019 Dec;50(12):e344-e418
pubmed: 31662037
Circ Cardiovasc Qual Outcomes. 2020 Apr;13(4):e006631
pubmed: 32182131