Department of Neurological Sciences, Rush University Medical Center, 1725 W Harrison St. Suite 1121, Chicago, IL, 60612, USA.
Neurol Sci. 2022 Apr;43(4):2211-2215. doi: 10.1007/s10072-021-05826-7. Epub 2022 Jan 22.
We sought to analyze the effect of COVID-19 on telestroke requests and to characterize patients remotely evaluated for acute ischemic stroke (AIS) during this time. This study is a retrospective database review of all telestroke requests at one academic vascular neurology center telestroke network with seven remote sites in the USA between March 15 and April 30, 2020. Data were compared with historical cohort spanning same time frame in 2019 using parametric or nonparametric methods as appropriate. Among telestroke requests, characteristics of age, gender, race/ethnicity, National Institutes of Health Stroke Scale (NIHSS), primary diagnosis of AIS or transient ischemic attack (TIA), and number of patients receiving intravenous alteplase (IV-rtPA) and endovascular therapy (ET) were recorded. There was a 53% decrease in telestroke evaluation requests in 2020 from 2019 (p < 0.00001). Mean NIHSS in 2020 was 9.1 (SD ± 8.4) and mean NIHSS in 2019 was 7.2 (SD ± 7.3) (p = 0.122). Among patients with primary diagnosis of suspected AIS or TIA, mean age was 60.5 years in 2020 (SD ± 17.5) and mean age of 67.0 years in 2019 (SD ± 16.0) (p = 0.038). A significant lower number of telestroke evaluations were performed with a higher mean NIHSS overall and a lower mean age among AIS/TIA-suspected patients. Higher NIHSS and severity in all telestroke evaluations reflect neurological manifestations of AIS and mimics, possibly influenced by COVID-19. The younger age of those with suspected AIS or TIA reflects thrombotic complications in atypical stroke populations.
我们旨在分析 COVID-19 对远程卒中请求的影响，并描述在此期间远程评估急性缺血性卒中（AIS）的患者特征。这项研究是对美国一个学术血管神经病学中心远程卒中网络的所有远程卒中请求进行的回顾性数据库研究，该网络在 2020 年 3 月 15 日至 4 月 30 日期间与美国的 7 个远程站点进行了合作。使用参数或非参数方法对数据进行比较，具体取决于历史队列在 2019 年同期的情况。在远程卒中请求中，记录了年龄、性别、种族/民族、国立卫生研究院卒中量表（NIHSS）、AIS 或短暂性脑缺血发作（TIA）的主要诊断、接受静脉注射阿替普酶（IV-rtPA）和血管内治疗（ET）的患者数量等特征。与 2019 年同期相比，2020 年远程卒中评估请求减少了 53%（p<0.00001）。2020 年的平均 NIHSS 为 9.1（SD±8.4），2019 年的平均 NIHSS 为 7.2（SD±7.3）（p=0.122）。在 AIS/TIA 疑似患者中，2020 年的主要诊断患者平均年龄为 60.5 岁（SD±17.5），2019 年的主要诊断患者平均年龄为 67.0 岁（SD±16.0）（p=0.038）。总体而言，进行的远程卒中评估数量较少，平均 NIHSS 较高，疑似 AIS/TIA 患者的平均年龄较低。所有远程卒中评估中较高的 NIHSS 和严重程度反映了 AIS 和模拟物的神经表现，可能受 COVID-19 影响。疑似 AIS 或 TIA 患者的年龄较轻反映了非典型卒中人群中的血栓并发症。
