A Chilean Experience of Telestroke in a COVID-19 Pandemic Year.


Journal

Cerebrovascular diseases (Basel, Switzerland)
ISSN: 1421-9786
Titre abrégé: Cerebrovasc Dis
Pays: Switzerland
ID NLM: 9100851

Informations de publication

Date de publication:
2022
Historique:
received: 14 01 2022
accepted: 25 02 2022
pubmed: 8 4 2022
medline: 24 8 2022
entrez: 7 4 2022
Statut: ppublish

Résumé

Telemedicine for stroke patients' care (telestroke [TS]) has grown notably in recent decades and may offer advantages during health crisis. Hospital admissions related to stroke have decreased globally during the COVID-19 pandemic, but scarce information is available regarding the effect of COVID-19 in TS. Using a population-based TS registry, we investigated the impact of the first year of the COVID-19 pandemic throughout our TS network in Santiago, Chile. Stroke codes evaluated after the onset of COVID-19 restrictions in Chile (defined as March 15, 2020) were compared with those evaluated in 2019. We analyzed differences between number of stroke codes, thrombolysis rate, stroke severity, and time from the stroke onset to hospital admission. We observed that the number of stroke codes and the number of patients undergoing reperfusion therapy did not change significantly (p = 0.669 and 0.415, respectively). No differences were found with respect to the median time from the stroke onset to admission (p = 0.581) or in National Institutes of Health Stroke Scale (NIHSS) scores (p = 0.055). The decision-making-to-needle time was significantly shorter in the COVID-19 period (median 5 min [IQR 3-8], p < 0.016), but no significant changes were found at the other times. This study demonstrates the potential of adapting TS to extreme situations such as the COVID-19 pandemic, as well as the importance of establishing networks that facilitate patient access to quality treatments.

Sections du résumé

BACKGROUND AND PURPOSE
Telemedicine for stroke patients' care (telestroke [TS]) has grown notably in recent decades and may offer advantages during health crisis. Hospital admissions related to stroke have decreased globally during the COVID-19 pandemic, but scarce information is available regarding the effect of COVID-19 in TS. Using a population-based TS registry, we investigated the impact of the first year of the COVID-19 pandemic throughout our TS network in Santiago, Chile.
METHODS
Stroke codes evaluated after the onset of COVID-19 restrictions in Chile (defined as March 15, 2020) were compared with those evaluated in 2019. We analyzed differences between number of stroke codes, thrombolysis rate, stroke severity, and time from the stroke onset to hospital admission.
RESULTS
We observed that the number of stroke codes and the number of patients undergoing reperfusion therapy did not change significantly (p = 0.669 and 0.415, respectively). No differences were found with respect to the median time from the stroke onset to admission (p = 0.581) or in National Institutes of Health Stroke Scale (NIHSS) scores (p = 0.055). The decision-making-to-needle time was significantly shorter in the COVID-19 period (median 5 min [IQR 3-8], p < 0.016), but no significant changes were found at the other times.
CONCLUSIONS
This study demonstrates the potential of adapting TS to extreme situations such as the COVID-19 pandemic, as well as the importance of establishing networks that facilitate patient access to quality treatments.

Identifiants

pubmed: 35390787
pii: 000523920
doi: 10.1159/000523920
pmc: PMC9148905
doi:

Types de publication

News

Langues

eng

Sous-ensembles de citation

IM

Pagination

690-694

Informations de copyright

© 2022 S. Karger AG, Basel.

Auteurs

Carlos Delfino (C)

Centro de Estudios Clínicos, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile, cdelfino@udd.cl.

Enrico Mazzon (E)

Centro de Estudios Clínicos, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile.
Unidad de TeleACV, Servicio de Salud Metropolitano Sur, Santiago, Chile.
Department of Neurology and Psychiatry, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.

Gabriel Cavada (G)

Research and Clinical Trials Unit, Department of Academic Development and Research, Clínica Alemana de Santiago, Santiago, Chile.
School of Public Health, Facultad de Medicina, Universidad de Chile, Santiago, Chile.

Paula Muñoz Venturelli (P)

Centro de Estudios Clínicos, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile.
Department of Neurology and Psychiatry, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.

Alejandro M Brunser (AM)

Unidad de TeleACV, Servicio de Salud Metropolitano Sur, Santiago, Chile.
Department of Neurology and Psychiatry, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
Department of General Emergency, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.

Felipe Jurado Díaz (F)

Unidad de TeleACV, Servicio de Salud Metropolitano Sur, Santiago, Chile.
Department of Neurology and Neurosurgery, Facultad de Medicina, Universidad de Chile, Santiago, Chile.

Lorena Lara Cisternas (LL)

Unidad de TeleACV, Servicio de Salud Metropolitano Sur, Santiago, Chile.

Diego Rocha Jiménez (D)

Unidad de TeleACV, Servicio de Salud Metropolitano Sur, Santiago, Chile.

Mirya Arévalo Valdivia (M)

Unidad de TeleACV, Servicio de Salud Metropolitano Sur, Santiago, Chile.

Diego Rojas Torres (D)

Unidad de TeleACV, Servicio de Salud Metropolitano Sur, Santiago, Chile.

Eloy Mansilla (E)

Centro de Estudios Clínicos, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile.
Unidad de TeleACV, Servicio de Salud Metropolitano Sur, Santiago, Chile.
Department of Neurology and Psychiatry, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
Department of Neurology and Neurosurgery, Facultad de Medicina, Universidad de Chile, Santiago, Chile.

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