TY - JOUR
T1 - COVID-19 Impact on Acute Ischemic Stroke Treatment at 9 Comprehensive Stroke Centers across Los Angeles
AU - Padrick, M. Maximillian
AU - Sangha, Navdeep
AU - Paletz, Laurie
AU - Mirocha, James
AU - Figueroa, Sonia
AU - Manoukian, Vicki
AU - Schlick, Konrad
AU - Lyden, Patrick D.
AU - Liebeskind, David S.
AU - Chatfield, Fiona K.
AU - Tarpley, Jason W.
AU - Burgos, Adrian
AU - Tenser, Matthew
AU - Gaffney, Denise
AU - Pech, Marco A.
AU - Nazareth, Edward
AU - Jackson, Robert
AU - Kauffman, Helaine
AU - Arnold, Lisa
AU - Cox, Jennifer
AU - Joyce, Treasure
AU - Nakamura, Catrice
AU - Fitzgerald, Darcie
AU - Ogami, Kyle
AU - Steiner, Nili
AU - Wolber, Nicole
AU - Robertson, Betty
AU - Izzo, Rachel
AU - Gorski, Stefanie
AU - Manuel, Heather
AU - Valdez, Krystal
AU - Reyes, Liliana
AU - Sharma, Latisha K.
AU - Song, Shlee S.
N1 - Publisher Copyright:
© 2021
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Objective: To describe the impact of COVID-19 on acute cerebrovascular disease care across 9 comprehensive stroke centers throughout Los Angeles County (LAC). Methods: Volume of emergency stroke code activations, patient characteristics, stroke severity, reperfusion rates, treatment times, and outcomes from February 1 to April 30, 2020, were compared against the same time period in 2019. Demographic data were provided by each participating institution. Results: There was a 17.3% decrease in stroke code activations across LAC in 2020 compared to 2019 (1,786 vs. 2,159, respectively, goodness of fit test p < 0.0001) across 9 participating comprehensive stroke centers. Patients who did not receive any reperfusion therapy decreased by 16.6% in 2020 (1,527) compared to 2019 (1,832). Patients who received only intravenous thrombolytic (IVT) therapy decreased by 31.8% (107 vs. 157). Patients who received only mechanical thrombectomy (MT) increased by 3% (102 vs. 99). Patients who received both IVT and MT decreased by 31.8% (45 vs. 66). Recanalization treatment times in 2020 were comparable to 2019. CSCs serving a higher proportion of Latinx populations in the eastern parts of LAC experienced a higher incidence of MT in 2020 compared to 2019. Mild increase in stroke severity was seen in 2020 compared to 2019 (8.95 vs. 8.23, p = 0.046). A higher percentage of patients were discharged home in 2020 compared to 2019 (59.5 vs. 56.1%, p = 0.034), a lower percentage of patients were discharged to skilled nursing facility (16.1 vs. 20.7%, p = 0.0004), and a higher percentage of patients expired (8.6 vs. 6.3%, p = 0.008). Conclusion: LAC saw a decrease in overall stroke code activations in 2020 compared to 2019. Reperfusion treatment times remained comparable to prepandemic metrics. There has been an increase in severe stroke incidence and higher volume of thrombectomy treatments in Latinx communities within LAC during the pandemic of 2020. More patients were discharged home, less patients discharged to skilled nursing facilities, and more patients expired in 2020, compared to the same time frame in 2019.
AB - Objective: To describe the impact of COVID-19 on acute cerebrovascular disease care across 9 comprehensive stroke centers throughout Los Angeles County (LAC). Methods: Volume of emergency stroke code activations, patient characteristics, stroke severity, reperfusion rates, treatment times, and outcomes from February 1 to April 30, 2020, were compared against the same time period in 2019. Demographic data were provided by each participating institution. Results: There was a 17.3% decrease in stroke code activations across LAC in 2020 compared to 2019 (1,786 vs. 2,159, respectively, goodness of fit test p < 0.0001) across 9 participating comprehensive stroke centers. Patients who did not receive any reperfusion therapy decreased by 16.6% in 2020 (1,527) compared to 2019 (1,832). Patients who received only intravenous thrombolytic (IVT) therapy decreased by 31.8% (107 vs. 157). Patients who received only mechanical thrombectomy (MT) increased by 3% (102 vs. 99). Patients who received both IVT and MT decreased by 31.8% (45 vs. 66). Recanalization treatment times in 2020 were comparable to 2019. CSCs serving a higher proportion of Latinx populations in the eastern parts of LAC experienced a higher incidence of MT in 2020 compared to 2019. Mild increase in stroke severity was seen in 2020 compared to 2019 (8.95 vs. 8.23, p = 0.046). A higher percentage of patients were discharged home in 2020 compared to 2019 (59.5 vs. 56.1%, p = 0.034), a lower percentage of patients were discharged to skilled nursing facility (16.1 vs. 20.7%, p = 0.0004), and a higher percentage of patients expired (8.6 vs. 6.3%, p = 0.008). Conclusion: LAC saw a decrease in overall stroke code activations in 2020 compared to 2019. Reperfusion treatment times remained comparable to prepandemic metrics. There has been an increase in severe stroke incidence and higher volume of thrombectomy treatments in Latinx communities within LAC during the pandemic of 2020. More patients were discharged home, less patients discharged to skilled nursing facilities, and more patients expired in 2020, compared to the same time frame in 2019.
KW - COVID
KW - Door-to-groin puncture time
KW - Door-toneedle time
KW - Ischemic stroke
KW - Los Angeles
KW - Reperfusion
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85110227515&partnerID=8YFLogxK
U2 - 10.1159/000516908
DO - 10.1159/000516908
M3 - Article
C2 - 34175851
AN - SCOPUS:85110227515
SN - 1015-9770
VL - 50
SP - 707
EP - 714
JO - Cerebrovascular Diseases
JF - Cerebrovascular Diseases
IS - 6
ER -