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A recent publication in PLOS ONE assessed the effects of the 2019 coronavirus disease (COVID-19) pandemic on stroke code (SC) measures.
Spain is one of the countries most affected by the COVID-19 pandemic through severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). More than 70,000 cases of COVID-19 have been registered in the Community of Madrid (CM) so far. June 15, 2020. This crisis overshadowed other pathologies, resulting in really extensive interference in fitness systems.
Acute stroke is the leading cause of death in adults and the leading cause of death at the moment worldwide. Therapies evolved over the past 3 decades have reduced mortality in patients with acute ischemic stroke. However, clinical outcomes count on time from onset of symptoms and reperfusion. therapy.
Reports recommend that each and every minute stored at startup increases sequelae-free shelf life for a week. The detection of calls with suspected acute stroke, the dispatch of an ambulance, the on-site assessment of the patient, the variety of the nearest suitable hospital), the alert of the neurologists on call and the immediate transfer of patients constitute the SC protocol.
The implementation of the SC protocol has particularly reduced treatment time, with consequences for patient outcomes. Disruptions in SC protocol capacity may have an effect on stroke care and worsen patient outcomes. Several study teams have warned of a drastic drop in AS cases, delays in ambulance facilities, and saturation of call centers and hospital emergency services during the first wave of the COVID-19 pandemic. However, there is little data on which facilities are most affected in the pre-hospital and inpatient stages of AS urgent care.
In the existing study, researchers evaluated the effect of the COVID-19 pandemic on the SC protocol in the CM. The main objective was to compare the time spent on each phase of the SC protocol in pre-COVID-19 (February 27 – June 15, 2019) and during the first wave of COVID-19 (same was in 2020) in CM. The secondary objective was to compare other basic facets of CS (diagnostic accuracy and hospital death, among others) between the two eras
The study included the SC cohort of the Madrid Emergency Medical Service (SUMMA 112) and discharge data from 10 hospitals with a stroke unit. Patients who met the SC criteria were eligible for inclusion. Patients were excluded if they had a fitness identity number (HIN) or minimum basic knowledge set (MBDS).
The time elapsed at each of the levels of the prehospital cesarean section procedure was analyzed. In the prehospital phase, data were collected on sex, age, important signs, suspected giant vessel occlusion (LVO), place of admission of the patient and Glasgow coma scale. The prestige of patient severity was assessed 1) Charlson Comorbidity Index (CHF), 2) severity and threat of mortality, and 3) hospital death.
The SC protocol was activated for 966 patients, 514 in the pre-COVID-19 era and 452 in the pandemic. During the COVID-19 era, activation of the SC protocol decreased by 6. 4% compared to the corresponding pre-pandemic era.
During the COVID-19 period, patients were younger and predominantly male. Vital signs, ICC, severity, and threat of mortality were not statistically different between the two time periods. The proportion of patients who underwent a pre-hospital electrogram decreased by 10%. pandemic.
Hospital mortality fell from 14% to 9% during the pandemic, although statistically insignificant. During the pandemic, call control time through the coordination center and on-site dwell time increased by 9% and 12% respectively compared to the pre-pandemic period. The median length of stay (MDS) in hospital has also increased by more than 3% during the pandemic.
Differences in the proportion of patients treated with intravenous thrombolysis (IVT) or mechanical thrombectomy (MT) between the 2 periods were not significant. Similarly, hospital mortality was not especially different between the 2 periods, although it did decrease in the COVID-19 period.
In summary, the researchers observed that 112 call center reaction times and on-site time increased by more than 10% during the first wave of COVID-19, although ambulance transit time was not particularly affected.
However, the diagnostic accuracy of emergency medical facility (EMS) professionals has not been affected by the pandemic. The proportion of patients treated with TM or TTI during the pandemic was not particularly different from the pre-pandemic period, underscoring the resilience of the stroke network. .
Written By
Tarun was founded in Hyderabad, India. He holds a Master’s degree in Biotechnology from the University of Hyderabad and is passionate about clinical studies. She enjoys reading study articles and literature reviews and is passionate about writing.
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