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Telestroke: Maintaining Quality Acute Stroke Care During the COVID-19 Pandemic

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted acute stroke care globally. Decreased stroke presentations and concern for delays in acute stroke care have been identified. This study evaluated the impact of COVID-19 on the timely treatment of patients with...

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Autores principales: Sevilis, Theresa, McDonald, Mark, Avila, Amanda, Heath, Gregory, Gao, Lan, O'Brien, Gayle, Zaman, Mohammed, Heller, Adam, Masud, Muhammad, Mowzoon, Nima, Devlin, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc., publishers 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9058863/
https://www.ncbi.nlm.nih.gov/pubmed/34265222
http://dx.doi.org/10.1089/tmj.2021.0149
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author Sevilis, Theresa
McDonald, Mark
Avila, Amanda
Heath, Gregory
Gao, Lan
O'Brien, Gayle
Zaman, Mohammed
Heller, Adam
Masud, Muhammad
Mowzoon, Nima
Devlin, Thomas
author_facet Sevilis, Theresa
McDonald, Mark
Avila, Amanda
Heath, Gregory
Gao, Lan
O'Brien, Gayle
Zaman, Mohammed
Heller, Adam
Masud, Muhammad
Mowzoon, Nima
Devlin, Thomas
author_sort Sevilis, Theresa
collection PubMed
description INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted acute stroke care globally. Decreased stroke presentations and concern for delays in acute stroke care have been identified. This study evaluated the impact of COVID-19 on the timely treatment of patients with thrombolytics at hospitals utilizing telestroke acute stroke services. METHODS: Acute stroke consultations seen in 171 hospitals (19 states) via telestroke from December 1, 2019, to June 27, 2020, were extracted from the TeleCare™ database. The consults were divided into pre-COVID and COVID groups (March 15, 2020, start of COVID group). The consults were reviewed for age, sex, hospital, state, date seen, last known normal, arrival time, consult call time, needle time, thrombolytic candidate, and National Institutes of Health Stroke Scale (NIHSS) score. The total number of consults, median door to needle (DTN) time for emergency department (ED) patients, and call to needle (CTN) time for inpatients were calculated. RESULTS: Pre-COVID, 15,226 stroke consults were evaluated compared with 11,105 in the COVID group, a 27% decrease. Pre-COVID, 1,071 ED patients (7.9%) received thrombolytics and 66 inpatients (4.0%), while COVID, 813 ED patients (8.2%) and 70 inpatients (5.7%). The median DTN time for ED patients pre-COVID was 42 (32, 55) versus 40 (31, 52) in the COVID group, with no statistically significant difference between groups. CTN time pre-COVID was 53 (35, 67) versus 46 (35, 61) in the COVID group, with no statistically significant difference between groups. CONCLUSIONS: Telestroke assessments allowed for uninterrupted acute stroke care and treatment stability despite nursing and other resource realignments triggered by the COVID-19 pandemic.
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spelling pubmed-90588632022-05-02 Telestroke: Maintaining Quality Acute Stroke Care During the COVID-19 Pandemic Sevilis, Theresa McDonald, Mark Avila, Amanda Heath, Gregory Gao, Lan O'Brien, Gayle Zaman, Mohammed Heller, Adam Masud, Muhammad Mowzoon, Nima Devlin, Thomas Telemed J E Health Original Research INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted acute stroke care globally. Decreased stroke presentations and concern for delays in acute stroke care have been identified. This study evaluated the impact of COVID-19 on the timely treatment of patients with thrombolytics at hospitals utilizing telestroke acute stroke services. METHODS: Acute stroke consultations seen in 171 hospitals (19 states) via telestroke from December 1, 2019, to June 27, 2020, were extracted from the TeleCare™ database. The consults were divided into pre-COVID and COVID groups (March 15, 2020, start of COVID group). The consults were reviewed for age, sex, hospital, state, date seen, last known normal, arrival time, consult call time, needle time, thrombolytic candidate, and National Institutes of Health Stroke Scale (NIHSS) score. The total number of consults, median door to needle (DTN) time for emergency department (ED) patients, and call to needle (CTN) time for inpatients were calculated. RESULTS: Pre-COVID, 15,226 stroke consults were evaluated compared with 11,105 in the COVID group, a 27% decrease. Pre-COVID, 1,071 ED patients (7.9%) received thrombolytics and 66 inpatients (4.0%), while COVID, 813 ED patients (8.2%) and 70 inpatients (5.7%). The median DTN time for ED patients pre-COVID was 42 (32, 55) versus 40 (31, 52) in the COVID group, with no statistically significant difference between groups. CTN time pre-COVID was 53 (35, 67) versus 46 (35, 61) in the COVID group, with no statistically significant difference between groups. CONCLUSIONS: Telestroke assessments allowed for uninterrupted acute stroke care and treatment stability despite nursing and other resource realignments triggered by the COVID-19 pandemic. Mary Ann Liebert, Inc., publishers 2022-04-01 2022-04-19 /pmc/articles/PMC9058863/ /pubmed/34265222 http://dx.doi.org/10.1089/tmj.2021.0149 Text en © Theresa Sevilis et al. 2022; Published by Mary Ann Liebert, Inc. https://creativecommons.org/licenses/by/4.0/This Open Access article is distributed under the terms of the Creative Commons License [CC-BY] (http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Sevilis, Theresa
McDonald, Mark
Avila, Amanda
Heath, Gregory
Gao, Lan
O'Brien, Gayle
Zaman, Mohammed
Heller, Adam
Masud, Muhammad
Mowzoon, Nima
Devlin, Thomas
Telestroke: Maintaining Quality Acute Stroke Care During the COVID-19 Pandemic
title Telestroke: Maintaining Quality Acute Stroke Care During the COVID-19 Pandemic
title_full Telestroke: Maintaining Quality Acute Stroke Care During the COVID-19 Pandemic
title_fullStr Telestroke: Maintaining Quality Acute Stroke Care During the COVID-19 Pandemic
title_full_unstemmed Telestroke: Maintaining Quality Acute Stroke Care During the COVID-19 Pandemic
title_short Telestroke: Maintaining Quality Acute Stroke Care During the COVID-19 Pandemic
title_sort telestroke: maintaining quality acute stroke care during the covid-19 pandemic
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9058863/
https://www.ncbi.nlm.nih.gov/pubmed/34265222
http://dx.doi.org/10.1089/tmj.2021.0149
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