About: Acute Stroke Care in a New York City Comprehensive Stroke Center during the COVID-19 Pandemic

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About: Acute Stroke Care in a New York City Comprehensive Stroke Center during the COVID-19 Pandemic Goto Sponge NotDistinct Permalink

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

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Acute Stroke Care in a New York City Comprehensive Stroke Center during the COVID-19 Pandemic
Creator	Kim, Sun Nelson, Peter Frontera, Jennifer Agarwal, Shashank Ishida, Koto Lord, Aaron Mph, M Riina, Howard Tanweer, Omar Yaghi, Shadi Humbert, Kelley Nossek, Erez Raz, Eytan Shapiro, Maksim Torres, Jose Arcot, Karthikeyan Caldwell, Reed Farkas, Jeffrey Liff, Jeremy Marolia, Dilshad Parella, David Rossan-Raghunath, Nirmala Sanger, Matthew Scher, Erica Tiwari, Ambooj Wachs, Michael Wittman, Ian Wu, Tina Zhang, Cen De Havenon, Adam Mha, Michael Mpa, Mariya Mph, R Rossan-Raghunath Rn, Nirmala St, Th Turkel Parella, David
Source	Elsevier; Medline; PMC
abstract	BACKGROUND AND PURPOSE: The coronavirus disease-2019 (COVID-19) pandemic caused unprecedented demand and burden on emergency health care services in New York City. We aim to describe our experience providing acute stroke care at a comprehensive stroke center (CSC) and the impact of the pandemic on the quality of care for patients presenting with acute ischemic stroke (AIS). METHODS: We retrospectively analyzed data from a quality improvement registry of consecutive AIS patients at New York University Langone Health's CSC between 06/01/2019-05/15/2020. During the early stages of the pandemic, the acute stroke process was modified to incorporate COVID-19 screening, testing, and other precautionary measures. We compared stroke quality metrics including treatment times and discharge outcomes of AIS patients during the pandemic (03/012020-05/152020) compared with a historical pre-pandemic group (6/1/2019-2/29/2020). RESULTS: A total of 754 patients (pandemic-120; pre-pandemic-634) were admitted with a principal diagnosis of AIS; 198 (26.3%) received alteplase and/or mechanical thrombectomy. Despite longer median door to head CT times (16 vs 12 minutes; p=0.05) and a trend towards longer door to groin puncture times (79.5 vs. 71 minutes, p=0.06), the time to alteplase administration (36 vs 35 minutes; p=0.83), door to reperfusion times (103 vs 97 minutes, p=0.18) and defect-free care (95.2% vs 94.7%; p=0.84) were similar in the pandemic and pre-pandemic groups. Successful recanalization rates (TICI≥2b) were also similar (82.6% vs. 86.7%, p=0.48). After adjusting for stroke severity, age and a prior history of transient ischemic attack/stroke, pandemic patients had increased discharge mortality (adjusted OR 2.90 95% CI 1.77 – 7.17, p = 0.021) CONCLUSION: Despite unprecedented demands on emergency healthcare services, early multidisciplinary efforts to adapt the acute stroke treatment process resulted in keeping the stroke quality time metrics close to pre-pandemic levels. Future studies will be needed with a larger cohort comparing discharge and long-term outcomes between pre-pandemic and pandemic AIS patients.
has issue date	2020-06-20(xsd:dateTime)
bibo:doi	10.1016/j.jstrokecerebrovasdis.2020.105068
bibo:pmid	32807471
has license	no-cc
sha1sum (hex)	8081c9af069525ae235404808d2972be09a2fc31
schema:url	https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105068
resource representing a document's title	Acute Stroke Care in a New York City Comprehensive Stroke Center during the COVID-19 Pandemic
has PubMed Central identifier	PMC7305900
has PubMed identifier	32807471
schema:publication	J Stroke Cerebrovasc Dis
resource representing a document's body	covid:8081c9af069525ae235404808d2972be09a2fc31#body_text
is schema:about of	named entity 'Humbert' named entity 'MHA' named entity 'Frontera' named entity 'Jeffrey' named entity 'Center' named entity 'Care' named entity 'ORG' named entity 'MPH' named entity 'WORDS' named entity 'Tables' named entity 'Manuscript' named entity 'Wittman' named entity 'Reed' named entity 'Sanger' named entity 'Erez' named entity 'COVID' named entity 'COVID-19' named entity 'risk factors' named entity 'COVID-19 testing' named entity 'Neurological examination' named entity 'AIS' named entity 'aphasia' named entity 'demographic' named entity 'Stroke' named entity 'healthcare worker' named entity 'clinical outcomes' named entity 'acute stroke' named entity 'emergency health care' named entity 'alteplase' named entity 'reperfusion therapy' named entity '12 minutes' named entity 'PPE' named entity 'infection' named entity 'stroke' named entity 'acute stroke' named entity 'statin medication' named entity 'AIS' named entity 'thrombolysis' named entity 'coronavirus disease 2019' named entity 'RT-PCR' named entity 'vessel occlusion' named entity 'P-values' named entity 'acute stroke' named entity 'neurological exam' named entity 'thrombolytic therapy' named entity 'symptom'

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