Maintenance of Acute Stroke Care Service During the COVID-19 Pandemic Lockdown

DOI Web Site 被引用文献2件
  • Valerian L. Altersberger
    Stroke Center and Department of Neurology, University Hospital Basel and University of Basel, Switzerland (V.L.A., L.H.B., S.T.E.).
  • Lotte J. Stolze
    Department of Neurology, Amsterdam UMC, University of Amsterdam, the Netherlands (L.J.S., L.A.R., P.J.N.).
  • Mirjam R. Heldner
    Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Switzerland (M.R.H., U.F, M.A.).
  • Hilde Henon
    University Lille, Inserm, CHU Lille, U1172- F-59000, France (H.H., C.C.).
  • Nicolas Martinez-Majander
    Neurology, University of Helsinki and Helsinki University Hospital, Finland (N.M.-M., S.C.).
  • Christian Hametner
    Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.A.R.).
  • Annika Nordanstig
    Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg (A.N., A.R.).
  • Andrea Zini
    IRCCS Istituto delle Scienze Neurologiche di Bologna, Department of Neurology and Stroke Center, Maggiore Hospital, Bologna, Italy (A.Z., M.G.).
  • Stefania Nannoni
    Department of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland (S.N., P.M.).
  • Bruno Gonçalves
    Department of Neurology, Sainte-Anne Hospital, Paris, France Université Paris Descartes, France (B.G., G.T.).
  • Christian H. Nolte
    Klinik Neurologie mit Experimenteller Neurologie, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany and Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin Berlin, Germany (C.H.N., J.F.S.).
  • Philipp Baumgartner
    Zurich Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland (P.B., S.W.).
  • Andreas Kastrup
    Departments of Neurology and Neuroradiology, Klinikum Bremen-Mitte, Germany (A.K., P.P.).
  • Panagiotis Papanagiotou
    Departments of Neurology and Neuroradiology, Klinikum Bremen-Mitte, Germany (A.K., P.P.).
  • Georg Kägi
    Department of Neurology, Kantonsspital St. Gallen, Switzerland (G.K.).
  • Ronen R. Leker
    Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel (R.R.L.).
  • Marialuisa Zedde
    Neurology Unit, Neuromotor & Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy (M.Z.).
  • Alessandro Padovani
    Neurology Section, Department of Clinical and Experimental Sciences, University of Brescia; Neurology Unit, ASST Spedali Civili, Italy (A. Padovani, A. Pezzini).
  • Alessandro Pezzini
    Neurology Section, Department of Clinical and Experimental Sciences, University of Brescia; Neurology Unit, ASST Spedali Civili, Italy (A. Padovani, A. Pezzini).
  • Visnja Padjen
    Neurology Clinic, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia (V.P.).
  • Carlo W. Cereda
    University Lille, Inserm, CHU Lille, U1172- F-59000, France (H.H., C.C.).
  • Georges Ntaios
    Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece (G.N.).
  • Leo H. Bonati
    Stroke Center and Department of Neurology, University Hospital Basel and University of Basel, Switzerland (V.L.A., L.H.B., S.T.E.).
  • Leon A. Rinkel
    Department of Neurology, Amsterdam UMC, University of Amsterdam, the Netherlands (L.J.S., L.A.R., P.J.N.).
  • Urs Fischer
    Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Switzerland (M.R.H., U.F, M.A.).
  • Jan F. Scheitz
    Klinik Neurologie mit Experimenteller Neurologie, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany and Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin Berlin, Germany (C.H.N., J.F.S.).
  • Susanne Wegener
    Zurich Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland (P.B., S.W.).
  • Guillaume Turc
    Department of Neurology, Sainte-Anne Hospital, Paris, France Université Paris Descartes, France (B.G., G.T.).
  • Patrik Michel
    Department of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland (S.N., P.M.).
  • Mauro Gentile
    IRCCS Istituto delle Scienze Neurologiche di Bologna, Department of Neurology and Stroke Center, Maggiore Hospital, Bologna, Italy (A.Z., M.G.).
  • Alexandros Rentzos
    Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg (A.N., A.R.).
  • Peter A. Ringleb
    Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.A.R.).
  • Sami Curtze
    Neurology, University of Helsinki and Helsinki University Hospital, Finland (N.M.-M., S.C.).
  • Charlotte Cordonnier
  • Marcel Arnold
    Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Switzerland (M.R.H., U.F, M.A.).
  • Paul J. Nederkoorn
    Department of Neurology, Amsterdam UMC, University of Amsterdam, the Netherlands (L.J.S., L.A.R., P.J.N.).
  • Stefan T. Engelter
    Stroke Center and Department of Neurology, University Hospital Basel and University of Basel, Switzerland (V.L.A., L.H.B., S.T.E.).
  • Henrik Gensicke
    Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Switzerland (S.T.E., H.G.).

抄録

<jats:sec> <jats:title>Background and Purpose:</jats:title> <jats:p>Timely reperfusion is an important goal in treatment of eligible patients with acute ischemic stroke. However, during the coronavirus disease 2019 (COVID-19) pandemic, prehospital and in-hospital emergency procedures faced unprecedented challenges, which might have caused a decline in the number of acute reperfusion therapy applied and led to a worsening of key quality measures for this treatment during lockdown.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>This prospective multicenter cohort study used data from the TRISP (Thrombolysis in Ischemic Stroke Patients) registry of patients with acute ischemic stroke treated with reperfusion therapies, that is, intravenous thrombolysis or endovascular therapy. We compared prehospital and in-hospital time-based performance measures (stroke-onset-to-admission, admission-to-treatment, admission-to-image, and image-to-treatment time) during the first 6 weeks after announcement of lockdown (lockdown period) with the same period in 2019 (reference period). Secondary outcomes included stroke severity (National Institutes of Health Stroke Scale) after 24 hours and occurrence of symptomatic intracranial hemorrhage (following the ECASS [European-Australasian Acute Stroke Study]-II criteria).</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>Across 20 stroke centers, 540 patients were treated with intravenous thrombolysis/endovascular therapy during lockdown period compared with 578 patients during reference period (−7% [95% CI, 5%–9%]). Performance measures did not change significantly during the lockdown period (2020/2019 minutes median: onset-to-admission 133/145; admission-to-treatment 51/48). Same was true for admission-to-image (20/19) and image-to-treatment (31/30) time in patients with available time of first image (n=871, 77.9%). Median National Institutes of Health Stroke Scale on admission (2020/2019: 11/11) and after 24 hours (2020/2019: 6/5) and percentage of symptomatic intracranial hemorrhage (2020/2019: 6.2/5.7) did not differ significantly between both periods.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>The COVID-19 pandemic lockdown resulted in a mild decline in the number of patients with stroke treated with acute reperfusion therapies. More importantly, the solid stability of key quality performance measures between the 2020 and 2019 period may indicate resilience of acute stroke care service during the lockdown, at least in well-established European stroke centers.</jats:p> </jats:sec>

収録刊行物

  • Stroke

    Stroke 52 (5), 1693-1701, 2021-05

    Ovid Technologies (Wolters Kluwer Health)

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