Impact of COVID-19 Pandemic on a Regional Stroke Thrombectomy Service in the United Kingdom

被引：13

作者：

Kwan, Joseph ^{[1
,2
]}

Brown, Madison ^{[1
]}

Bentley, Paul ^{[1
,2
]}

Brown, Zoe ^{[1
]}

D'Anna, Lucio ^{[1
,2
]}

Hall, Charles ^{[3
]}

Halse, Omid ^{[1
]}

Jamil, Sohaa ^{[1
]}

Jenkins, Harri ^{[1
]}

Kalladka, Dheeraj ^{[1
]}

Patel, Maneesh ^{[3
]}

Rane, Neil ^{[3
]}

Singh, Abhinav ^{[3
]}

Taylor, Eleanor ^{[1
]}

Venter, Marius ^{[1
]}

Lobotesis, Kyriakos ^{[2
,3
]}

Banerjee, Soma ^{[1
,2
]}

机构：

[1] Imperial Coll London NHS Healthcare Trust, Dept Stroke Med, Fulham Palace Rd, London W6 8RF, England

[2] Imperial Coll London, Hammersmith Hosp, Dept Brain Sci, London, England

[3] Imperial Coll London NHS Healthcare Trust, Imaging Dept, Fulham Palace Rd, London W6 8RF, England

来源：

CEREBROVASCULAR DISEASES | 2021年 / 50卷 / 02期

关键词：

Stroke; Thrombectomy; Coronavirus disease 2019; Coronavirus; Pandemic; Health service; ACUTE ISCHEMIC-STROKE; CORONAVIRUS DISEASE 2019; CARE; RECOMMENDATIONS; ASSOCIATION; THERAPY; SOCIETY;

D O I：

10.1159/000512603

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Introduction: We examined the impact of the coronavirus disease 2019 (COVID-19) pandemic on our regional stroke thrombectomy service in the UK. Methods: This was a single-center health service evaluation. We began testing for COVID-19 on 3 March and introduced a modified "COVID Stroke Thrombectomy Pathway" on 18 March. We analyzed the clinical, procedural and outcome data for 61 consecutive stroke thrombectomy patients between 1 January and 30 April. We compared the data for January and February ("pre-COVID," n = 33) versus March and April ("during COVID," n = 28). Results: Patient demographics were similar between the 2 groups (mean age 71 +/- 12.8 years, 39% female). During the COVID-19 pandemic, (a) total stroke admissions fell by 17% but the thrombectomy rate was maintained at 20% of ischemic strokes; (b) successful recanalization rate was maintained at 81%; (c) early neurological outcomes (neurological improvement following thrombectomy and inpatient mortality) were not significantly different; (d) use of general anesthesia fell significantly from 85 to 32% as intended; and (e) time intervals from onset to arrival, groin puncture, and recanalization were not significantly different, whereas internal delays for external referrals significantly improved for door-to-groin puncture (48 [interquartile range (IQR) 39-57] vs. 33 [IQR 27-44] minutes, p = 0.013) and door-to-recanalization (82.5 [IQR 61-110] vs. 60 [IQR 55-70] minutes, p = 0.018). Conclusion: The COVID-19 pandemic has had a negative impact on the stroke admission numbers but not stroke thrombectomy rate, successful recanalization rate, or early neurological outcome. Internal delays actually improved during the COVID-19 pandemic. Further studies should examine the effects of the COVID-19 pandemic on longer term outcome.

引用

页码：178 / 184

页数：7

共 21 条

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STROKE, 2013, 44 (09) :2650-2663

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