Acute Stroke Presentation, Care, and Outcomes in Community Hospitals in Northern California During the COVID-19 Pandemic
Acute Stroke Presentation, Care, and Outcomes in Community Hospitals in Northern California During the COVID-19 Pandemic
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DOI：
10.1161/strokeaha.120.031099
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发表时间：
2020-10-01
期刊：
影响因子：
8.3
通讯作者：
Klingman, Jeffrey G.
中科院分区：
文献类型：
--
作者：
Nguyen-Huynh, Mai N.;Tang, Xian Nan;Klingman, Jeffrey G.
背景和目的：为缓解严重急性呼吸综合征冠状病毒2型传播而实施的就地庇护（SIP）命令可能会无意中阻碍患者在急性缺血性中风等危急情况下寻求护理的行为。我们的目的是比较SIP命令前后急性卒中警报量、患者特征、远程卒中护理和短期结局的时间趋势。方法：我们在一个综合医疗保健系统的21个卒中中心进行了一项队列研究，该系统为北方加州的440多万成员提供服务。我们纳入了2019年1月1日至2020年5月9日期间出现疑似急性中风并通过远程中风进行评估的成年患者。SIP订单公布了2020年3月15日的一周，创建了前（2019年1月1日至2020年3月14日）和后（2020年3月15日至2020年5月9日）队列进行比较。主要结局为卒中警报量和卒中住院死亡率。结果：与SIP前（平均132 [95%CI，130-136];P
Background and Purpose: Shelter-in-place (SIP) orders implemented to mitigate severe acute respiratory syndrome coronavirus 2 spread may inadvertently discourage patient care-seeking behavior for critical conditions like acute ischemic stroke. We aimed to compare temporal trends in volume of acute stroke alerts, patient characteristics, telestroke care, and short-term outcomes pre- and post-SIP orders. Methods: We conducted a cohort study in 21 stroke centers of an integrated healthcare system serving 4.4+ million members across Northern California. We included adult patients who presented with suspected acute stroke and were evaluated by telestroke between January 1, 2019, and May 9, 2020. SIP orders announced the week of March 15, 2020, created pre (January 1, 2019, to March 14, 2020) and post (March 15, 2020, to May 9, 2020) cohort for comparison. Main outcomes were stroke alert volumes and inpatient mortality for stroke. Results: Stroke alert weekly volume post-SIP (mean, 98 [95% CI, 92-104]) decreased significantly compared with pre-SIP (mean, 132 [95% CI, 130-136];P