Department of Neurosurgery and Neuroscience Institute, Geisinger Health System, Wilkes-Barre, PA, United States
Department of Neurosurgery, Geisinger Commonwealth School of Medicine, Scranton, PA, United States.
J Neurointerv Surg. 2020 Jul;12(7):639-642. doi: 10.1136/neurintsurg-2020-016299. Epub 2020 May 28.
The COVID-19 pandemic has disrupted established care paths worldwide. Patient awareness of the pandemic and executive limitations imposed on public life have changed the perception of when to seek care for acute conditions in some cases. We sought to study whether there is a delay in presentation for acute ischemic stroke patients in the first month of the pandemic in the US.
The interval between last-known-well (LKW) time and presentation of 710 consecutive patients presenting with acute ischemic strokes to 12 stroke centers across the US were extracted from a prospectively maintained quality database. We analyzed the timing and severity of the presentation in the baseline period from February to March 2019 and compared results with the timeframe of February and March 2020.
There were 320 patients in the 2-month baseline period in 2019, there was a marked decrease in patients from February to March of 2020 (227 patients in February, and 163 patients in March). There was no difference in the severity of the presentation between groups and no difference in age between the baseline and the COVID period. The mean interval from LKW to the presentation was significantly longer in the COVID period (603±1035 min) compared with the baseline period (442±435 min, P<0.02).
We present data supporting an association between public awareness and limitations imposed on public life during the COVID-19 pandemic in the US and a delay in presentation for acute ischemic stroke patients to a stroke center.
COVID-19 大流行扰乱了全球既定的护理路径。公众对大流行的认识以及对公众生活施加的行政限制，改变了某些情况下对急性疾病何时寻求治疗的看法。我们试图研究在美国 COVID-19 大流行的第一个月，急性缺血性中风患者的就诊是否出现延迟。
从美国 12 个中风中心的一个前瞻性维护的质量数据库中提取了 710 例连续急性缺血性中风患者的末次已知健康时间（last-known-well，LKW）和就诊时间之间的间隔。我们分析了 2019 年 2 月至 3 月基线期的就诊时间和严重程度，并将结果与 2020 年 2 月和 3 月的时间框架进行了比较。
2019 年 2 个月的基线期有 320 例患者，2020 年 2 月至 3 月期间患者数量明显减少（2 月 227 例，3 月 163 例）。两组的就诊严重程度无差异，基线期和 COVID 期间的年龄也无差异。LKW 到就诊的平均间隔在 COVID 期间明显延长（603±1035 分钟），与基线期相比（442±435 分钟，P<0.02）。
我们提供的数据支持了美国 COVID-19 大流行期间公众意识和对公众生活施加的限制与急性缺血性中风患者到中风中心就诊延迟之间存在关联。
