Article ; Online: COVID-19 Lockdown Effects on Acute Stroke Care in Latin America.
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
2021 Volume 30, Issue 9, Page(s) 105985
Abstract: ... lockdowns in stroke admissions and care in Latin America.: Materials and methods: A multinational study ... Conclusions: In this Latin America survey, there was a mild decrease in admissions of IS during the COVID-19 ... Objectives: COVID-19 pandemic has forced important changes in health care worldwide. Stroke care ...
| Abstract | Objectives: COVID-19 pandemic has forced important changes in health care worldwide. Stroke care networks have been affected, especially during peak periods. We assessed the impact of the pandemic and lockdowns in stroke admissions and care in Latin America. Materials and methods: A multinational study (7 countries, 18 centers) of patients admitted during the pandemic outbreak (March-June 2020). Comparisons were made with the same period in 2019. Numbers of cases, stroke etiology and severity, acute care and hospitalization outcomes were assessed. Results: Most countries reported mild decreases in stroke admissions compared to the same period of 2019 (1187 vs. 1166, p = 0.03). Among stroke subtypes, there was a reduction in ischemic strokes (IS) admissions (78.3% vs. 73.9%, p = 0.01) compared with 2019, especially in IS with NIHSS 0-5 (50.1% vs. 44.9%, p = 0.03). A substantial increase in the proportion of stroke admissions beyond 48 h from symptoms onset was observed (13.8% vs. 20.5%, p < 0.001). Nevertheless, no differences in total reperfusion treatment rates were observed, with similar door-to-needle, door-to-CT, and door-to-groin times in both periods. Other stroke outcomes, as all-type mortality during hospitalization (4.9% vs. 9.7%, p < 0.001), length of stay (IQR 1-5 days vs. 0-9 days, p < 0.001), and likelihood to be discharged home (91.6% vs. 83.0%, p < 0.001), were compromised during COVID-19 lockdown period. Conclusions: In this Latin America survey, there was a mild decrease in admissions of IS during the COVID-19 lockdown period, with a significant delay in time to consultations and worse hospitalization outcomes. |
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| MeSH term(s) | COVID-19/prevention & control ; COVID-19/transmission ; Cause of Death/trends ; Endovascular Procedures/adverse effects ; Endovascular Procedures/mortality ; Endovascular Procedures/trends ; Female ; Health Care Surveys ; Hospital Mortality/trends ; Hospitalization/trends ; Humans ; Latin America ; Length of Stay/trends ; Male ; Patient Admission/trends ; Patient Discharge/trends ; Practice Patterns, Physicians'/trends ; Stroke/diagnosis ; Stroke/mortality ; Stroke/therapy ; Time Factors ; Time-to-Treatment/trends ; Treatment Outcome | |||||
| Language | English | |||||
| Publishing date | 2021-07-03 | |||||
| Publishing country | United States | |||||
| Document type | Comparative Study ; Journal Article ; Multicenter Study | |||||
| ZDB-ID | 1131675-5 | |||||
| ISSN | 1532-8511 ; 1052-3057 | |||||
| ISSN (online) | 1532-8511 | |||||
| ISSN | 1052-3057 | |||||
| DOI | 10.1016/j.jstrokecerebrovasdis.2021.105985 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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