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Delays in Intracerebral Hemorrhage Management Is Associated with Hematoma Expansion and Worse Outcomes: Changes in COVID-19 Era

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic disrupted the emergency medical care system worldwide. We analyzed the changes in the management of intracerebral hemorrhage (ICH) and compared the pre-COVID-19 and COVID-19 eras. MATERIALS AND METHODS: From March to October of the COVID-19 e...

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Autores principales: Han, Hyun Jin, Park, Keun Young, Kim, Junhyung, Lee, Woosung, Lee, Yun Ho, Jang, Chang Ki, Cho, Kwang-Chun, Park, Sang Kyu, Chung, Joonho, Kwon, Young Sub, Kim, Yong Bae, Lee, Jae Whan, Kim, So Yeon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Yonsei University College of Medicine 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470569/
https://www.ncbi.nlm.nih.gov/pubmed/34558870
http://dx.doi.org/10.3349/ymj.2021.62.10.911
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author Han, Hyun Jin
Park, Keun Young
Kim, Junhyung
Lee, Woosung
Lee, Yun Ho
Jang, Chang Ki
Cho, Kwang-Chun
Park, Sang Kyu
Chung, Joonho
Kwon, Young Sub
Kim, Yong Bae
Lee, Jae Whan
Kim, So Yeon
author_facet Han, Hyun Jin
Park, Keun Young
Kim, Junhyung
Lee, Woosung
Lee, Yun Ho
Jang, Chang Ki
Cho, Kwang-Chun
Park, Sang Kyu
Chung, Joonho
Kwon, Young Sub
Kim, Yong Bae
Lee, Jae Whan
Kim, So Yeon
author_sort Han, Hyun Jin
collection PubMed
description PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic disrupted the emergency medical care system worldwide. We analyzed the changes in the management of intracerebral hemorrhage (ICH) and compared the pre-COVID-19 and COVID-19 eras. MATERIALS AND METHODS: From March to October of the COVID-19 era (2020), 83 consecutive patients with ICH were admitted to four comprehensive stroke centers. We retrospectively reviewed the data of patients and compared the treatment workflow metrics, treatment modalities, and clinical outcomes with the patients admitted during the same period of pre-COVID-19 era (2017–2019). RESULTS: Three hundred thirty-eight patients (83 in COVID-19 era and 255 in pre-COVID-19 era) were included in this study. Symptom onset/detection-to-door time [COVID-19; 56.0 min (34.0–106.0), pre-COVID-19; 40.0 min (27.0–98.0), p=0.016] and median door to-intensive treatment time differed between the two groups [COVID-19; 349.0 min (177.0–560.0), pre-COVID-19; 184.0 min (134.0–271.0), p<0.001]. Hematoma expansion was detected more significantly in the COVID-19 era (39.8% vs. 22.1%, p=0.002). At 3-month follow-up, clinical outcomes of patients were worse in the COVID-19 era (Good modified Rankin Scale; 33.7% in COVID19, 46.7% in pre-COVID-19, p=0.039). CONCLUSION: During the COVID-19 era, delays in management of ICH was associated with hematoma expansion and worse outcomes.
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spelling pubmed-84705692021-10-06 Delays in Intracerebral Hemorrhage Management Is Associated with Hematoma Expansion and Worse Outcomes: Changes in COVID-19 Era Han, Hyun Jin Park, Keun Young Kim, Junhyung Lee, Woosung Lee, Yun Ho Jang, Chang Ki Cho, Kwang-Chun Park, Sang Kyu Chung, Joonho Kwon, Young Sub Kim, Yong Bae Lee, Jae Whan Kim, So Yeon Yonsei Med J Original Article PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic disrupted the emergency medical care system worldwide. We analyzed the changes in the management of intracerebral hemorrhage (ICH) and compared the pre-COVID-19 and COVID-19 eras. MATERIALS AND METHODS: From March to October of the COVID-19 era (2020), 83 consecutive patients with ICH were admitted to four comprehensive stroke centers. We retrospectively reviewed the data of patients and compared the treatment workflow metrics, treatment modalities, and clinical outcomes with the patients admitted during the same period of pre-COVID-19 era (2017–2019). RESULTS: Three hundred thirty-eight patients (83 in COVID-19 era and 255 in pre-COVID-19 era) were included in this study. Symptom onset/detection-to-door time [COVID-19; 56.0 min (34.0–106.0), pre-COVID-19; 40.0 min (27.0–98.0), p=0.016] and median door to-intensive treatment time differed between the two groups [COVID-19; 349.0 min (177.0–560.0), pre-COVID-19; 184.0 min (134.0–271.0), p<0.001]. Hematoma expansion was detected more significantly in the COVID-19 era (39.8% vs. 22.1%, p=0.002). At 3-month follow-up, clinical outcomes of patients were worse in the COVID-19 era (Good modified Rankin Scale; 33.7% in COVID19, 46.7% in pre-COVID-19, p=0.039). CONCLUSION: During the COVID-19 era, delays in management of ICH was associated with hematoma expansion and worse outcomes. Yonsei University College of Medicine 2021-10-01 2021-09-10 /pmc/articles/PMC8470569/ /pubmed/34558870 http://dx.doi.org/10.3349/ymj.2021.62.10.911 Text en © Copyright: Yonsei University College of Medicine 2021 https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Han, Hyun Jin
Park, Keun Young
Kim, Junhyung
Lee, Woosung
Lee, Yun Ho
Jang, Chang Ki
Cho, Kwang-Chun
Park, Sang Kyu
Chung, Joonho
Kwon, Young Sub
Kim, Yong Bae
Lee, Jae Whan
Kim, So Yeon
Delays in Intracerebral Hemorrhage Management Is Associated with Hematoma Expansion and Worse Outcomes: Changes in COVID-19 Era
title Delays in Intracerebral Hemorrhage Management Is Associated with Hematoma Expansion and Worse Outcomes: Changes in COVID-19 Era
title_full Delays in Intracerebral Hemorrhage Management Is Associated with Hematoma Expansion and Worse Outcomes: Changes in COVID-19 Era
title_fullStr Delays in Intracerebral Hemorrhage Management Is Associated with Hematoma Expansion and Worse Outcomes: Changes in COVID-19 Era
title_full_unstemmed Delays in Intracerebral Hemorrhage Management Is Associated with Hematoma Expansion and Worse Outcomes: Changes in COVID-19 Era
title_short Delays in Intracerebral Hemorrhage Management Is Associated with Hematoma Expansion and Worse Outcomes: Changes in COVID-19 Era
title_sort delays in intracerebral hemorrhage management is associated with hematoma expansion and worse outcomes: changes in covid-19 era
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470569/
https://www.ncbi.nlm.nih.gov/pubmed/34558870
http://dx.doi.org/10.3349/ymj.2021.62.10.911
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