About: Acute Stroke Presentation, Care, and Outcomes in Community Hospitals in Northern California During the COVID-19 Pandemic

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About: Acute Stroke Presentation, Care, and Outcomes in Community Hospitals in Northern California During the COVID-19 Pandemic Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Acute Stroke Presentation, Care, and Outcomes in Community Hospitals in Northern California During the COVID-19 Pandemic
Creator	Alexander, Janet Burnett, Molly Flint, Alexander Klingman, Jeffrey Meighan, Melissa Nguyen-Huynh, Mai Sidney, Stephen Tang, Nan Vinson, David Xian, Mas
source	Medline; PMC
abstract	Shelter-in-place (SIP) orders implemented to mitigate severe acute respiratory syndrome coronavirus 2 spread may inadvertently discourage patient care-seeking behavior for critical conditions like acute ischemic stroke. We aimed to compare temporal trends in volume of acute stroke alerts, patient characteristics, telestroke care, and short-term outcomes pre- and post-SIP orders. METHODS: We conducted a cohort study in 21 stroke centers of an integrated healthcare system serving 4.4+ million members across Northern California. We included adult patients who presented with suspected acute stroke and were evaluated by telestroke between January 1, 2019, and May 9, 2020. SIP orders announced the week of March 15, 2020, created pre (January 1, 2019, to March 14, 2020) and post (March 15, 2020, to May 9, 2020) cohort for comparison. Main outcomes were stroke alert volumes and inpatient mortality for stroke. RESULTS: Stroke alert weekly volume post-SIP (mean, 98 [95% CI, 92–104]) decreased significantly compared with pre-SIP (mean, 132 [95% CI, 130–136]; P<0.001). Stroke discharges also dropped, in concordance with acute stroke alerts decrease. In total, 9120 patients were included: 8337 in pre- and 783 in post-SIP cohorts. There were no differences in patient demographics. Compared with pre-SIP, post-SIP patients had higher National Institutes of Health Stroke Scale scores (P=0.003), lower comorbidity score (P<0.001), and arrived more often by ambulance (P<0.001). Post-SIP, more patients had large vessel occlusions (P=0.03), and there were fewer stroke mimics (P=0.001). Discharge outcomes were similar for post-SIP and pre-SIP cohorts. CONCLUSIONS: In this cohort study, regional stroke alert and ischemic stroke discharge volumes decreased significantly in the early COVID-19 pandemic. Compared with pre-SIP, the post-SIP population showed no significant demographic differences but had lower comorbidity scores, more severe strokes, and more large vessel occlusions. The inpatient mortality was similar in both cohorts. Further studies are needed to understand the causes and implications of care avoidance to patients and healthcare systems.
has issue date	2020-08-17(xsd:dateTime)
bibo:doi	10.1161/strokeaha.120.031099
bibo:pmid	32762619
has license	no-cc
sha1sum (hex)	4e297194de7797eabf6390ce3dc52e60671f848e
schema:url	https://doi.org/10.1161/strokeaha.120.031099
resource representing a document's title	Acute Stroke Presentation, Care, and Outcomes in Community Hospitals in Northern California During the COVID-19 Pandemic
has PubMed Central identifier	PMC7434008
has PubMed identifier	32762619
schema:publication	Stroke
resource representing a document's body	covid:4e297194de7797eabf6390ce3dc52e60671f848e#body_text
is schema:about of	named entity 'care' named entity 'Outcomes' named entity 'TEMPORAL' named entity 'OUTCOMES' named entity 'PATIENT CARE' named entity 'LIKE' named entity 'PURPOSE' named entity 'SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2' named entity 'stroke' named entity 'patient care' named entity 'Shelter-in-place' named entity 'Stroke' named entity 'SIP' named entity 'comorbidity' named entity 'Stroke' named entity 'SIP' named entity 'NIHSS' named entity 'stroke symptoms' named entity 'stroke patients' named entity 'severe acute respiratory syndrome coronavirus 2' named entity 'potential complications' named entity 'stroke' named entity 'COVID-19 testing' named entity 'LVO' named entity 'stroke' named entity 'medical journals' named entity 'LVO' named entity 'needle time' named entity 'needle time' named entity 'stroke' named entity 'hemiplegia' named entity 'Kaiser Permanente' named entity 'adjusted odds ratio' named entity 'SAS Institute' named entity 'SIP' named entity 'comorbidity' named entity 'ischemic stroke' named entity 'myocardial infarction' named entity 'stroke' named entity 'stroke symptoms' named entity 'alteplase' named entity 'NIHSS' named entity 'intravenous' named entity 'stroke' named entity 'inpatient and outpatient' named entity 'LVO' named entity 'stroke' named entity 'SIP' named entity 'ischemic stroke' named entity 'COVID-19 pandemic' named entity 'COVID-19' named entity 'COVID-19' named entity 'ambulance' named entity 'acute stroke' named entity 'LVO' named entity 'infection' named entity 'stroke' named entity 'stroke' named entity 'hemiparesis' named entity 'medical centers' named entity 'SIP' named entity 'stroke' named entity 'stroke' named entity 'cerebral ischemic' named entity 'acute stroke' named entity 'stroke' named entity 'data analysis' named entity 'hypercoagulable state' named entity 'neurologist' named entity 'inpatient services' named entity 'LVO' named entity 'stroke'

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