Dataset Information

Impact of COVID-19 outbreak in reperfusion therapies of acute ischaemic stroke in northwest Spain.

ABSTRACT:

Background and purpose

Spain has been one of the countries more heavily stricken by SARS-CoV-2, which has had huge implications for stroke care. The aim was to analyse the impact of the COVID-19 epidemic outbreak on reperfusion therapies for acute ischaemic stroke in the northwest of Spain.

Methods

This was a Spanish multicentre retrospective observational study based on data from tertiary hospitals of the NORDICTUS network. All patients receiving reperfusion therapy for ischaemic stroke between 30 December 2019 and 3 May 2020 were recorded, and their baseline, clinical and radiological characteristics, extra- and intra-hospital times of action, Code Stroke activation pathway, COVID-19 status, reperfusion rate, and short-term outcome before and after the setting of the emergency state were analysed.

Results

A total of 796 patients received reperfusion therapies for ischaemic stroke. There was a decrease in the number of patients treated per week (46.5 patients per week vs. 39.0 patients per week, P = 0.043) and a delay in out-of-hospital (95.0 vs. 110.0 min, P = 0.001) and door-to-needle times (51.0 vs. 55.0, P = 0.038). Patients receiving endovascular therapy obtained less successful reperfusion rates (92.9% vs. 86.6%, P = 0.016). COVID-19 patients had more in-hospital mortality.

Conclusion

A decrease in the number of patients benefiting from reperfusion therapies was found, with a delay in out-of-hospital and door-to-needle times and worse reperfusion rates in northwest Spain. COVID-19 patients had more in-hospital mortality.

SUBMITTER: Tejada Meza H

PROVIDER: S-EPMC7436392 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

Impact of COVID-19 outbreak in reperfusion therapies of acute ischaemic stroke in northwest Spain.

Tejada Meza H H Lambea Gil Á Á Sancho Saldaña A A Martínez-Zabaleta M M Garmendia Lopetegui E E López-Cancio Martínez E E Castañón Apilánez M M Herrera Isasi M M Marta Enguita J J Gómez-Vicente B B Arenillas J F JF Arenaza Basterrechea N N Timiraos Fernández J J JJ Sánchez Herrero J J Maciñeiras Montero J L JL Castellanos Rodrigo M M Fernández-Coud D D Casado Menéndez I I Temprano Fernández M T MT Freijo M M Luna A A Palacio Portilla E J EJ Jiménez López Y Y Rodríguez-Castro E E Rodríguez-Yáñez M M Tejada García J J Beltrán Rodríguez I I Julián-Villaverde F F Moreno García M P MP Trejo Gabriel-Galán J M JM Echavarría Iñiguez A A Pérez Lázaro C C Navarro Pérez M P MP Marta Moreno J J

European journal of neurology 20200904 12

<h4>Background and purpose</h4>Spain has been one of the countries more heavily stricken by SARS-CoV-2, which has had huge implications for stroke care. The aim was to analyse the impact of the COVID-19 epidemic outbreak on reperfusion therapies for acute ischaemic stroke in the northwest of Spain.<h4>Methods</h4>This was a Spanish multicentre retrospective observational study based on data from tertiary hospitals of the NORDICTUS network. All patients receiving reperfusion therapy for ischaemic ...[more]

PMID: 32761981

Similar Datasets

Project description:ObjectiveTo assess differences in acute ischaemic stroke (AIS) in-hospital mortality between referral stroke hospitals and provide evidence on the association of those differences with the overtime adoption of effective reperfusion therapies.DesignRetrospective, longitudinal observational study using administrative data for virtually all hospital admissions from 2003 to 2015.SettingThirty-seven referral stroke hospitals in the Spanish National Health System.ParticipantsPatients aged 18 years and older with a hospital episode with an admission diagnosis of AIS in any referral stroke hospital (196 099 admissions). MAIN ENDPOINTS: (1) Hospital variation in 30-day in-hospital mortality measured in terms of the intraclass correlation coefficient (ICC); and (2) the difference in mortality between the hospital of treatment and the trend of utilisation of reperfusion therapies (including intravenous fibrinolysis and endovascular mechanical thrombectomy) in terms of median OR (MOR).ResultsAdjusted 30-day AIS in-hospital mortality decreased over the study period. Adjusted in-hospital mortality after AIS rates varied from 6.66% to 16.01% between hospitals. Beyond differences in patient characteristics, the relative contribution of the hospital of treatment was higher in the case of patients undergoing reperfusion therapies (ICC=0.031 (95% Bayesian credible interval (BCI)=0.017 to 0.057)) than in the case of those who did not (ICC=0.016 (95% BCI=0.010 to 0.026)). Using the MOR, the difference in risk of death was as high as 46% between the hospital with the highest risk and the hospital with the lowest risk of patients undergoing reperfusion therapy (MOR 1.46 (95% BCI 1.32 to 1.68)); in patients not undergoing any reperfusion therapy, the risk was 31% higher (MOR 1.31 (95% BCI 1.24 to 1.41)).ConclusionsIn the referral stroke hospitals of the Spanish National Health System, the overall adjusted in-hospital mortality decreased between 2003 and 2015. However, between-hospital variations in mortality persisted.

Dataset Information

Impact of COVID-19 outbreak in reperfusion therapies of acute ischaemic stroke in northwest Spain.

Background and purpose

Methods

Results

Conclusion

Publications

Impact of COVID-19 outbreak in reperfusion therapies of acute ischaemic stroke in northwest Spain.

Similar Datasets

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