Centro de Estudios Clínicos, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile,
Centro de Estudios Clínicos, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile.
Cerebrovasc Dis. 2022;51(5):690-694. doi: 10.1159/000523920. Epub 2022 Apr 7.
Telemedicine for stroke patients' care (telestroke [TS]) has grown notably in recent decades and may offer advantages during health crisis. Hospital admissions related to stroke have decreased globally during the COVID-19 pandemic, but scarce information is available regarding the effect of COVID-19 in TS. Using a population-based TS registry, we investigated the impact of the first year of the COVID-19 pandemic throughout our TS network in Santiago, Chile.
Stroke codes evaluated after the onset of COVID-19 restrictions in Chile (defined as March 15, 2020) were compared with those evaluated in 2019. We analyzed differences between number of stroke codes, thrombolysis rate, stroke severity, and time from the stroke onset to hospital admission.
We observed that the number of stroke codes and the number of patients undergoing reperfusion therapy did not change significantly (p = 0.669 and 0.415, respectively). No differences were found with respect to the median time from the stroke onset to admission (p = 0.581) or in National Institutes of Health Stroke Scale (NIHSS) scores (p = 0.055). The decision-making-to-needle time was significantly shorter in the COVID-19 period (median 5 min [IQR 3-8], p < 0.016), but no significant changes were found at the other times.
This study demonstrates the potential of adapting TS to extreme situations such as the COVID-19 pandemic, as well as the importance of establishing networks that facilitate patient access to quality treatments.
近几十年来，针对脑卒中患者的远程医疗（telestroke [TS]）发展显著，并且在卫生危机期间可能具有优势。在 COVID-19 大流行期间，全球范围内因脑卒中而住院的人数有所减少，但有关 COVID-19 对 TS 影响的信息却很少。本研究利用基于人群的 TS 登记处，调查了 COVID-19 在智利流行期间（定义为 2020 年 3 月 15 日），我们的 TS 网络中脑卒中患者的治疗情况。
比较了 COVID-19 限制在智利开始后评估的脑卒中代码（定义为 2020 年 3 月 15 日）与 2019 年评估的脑卒中代码。分析了脑卒中代码数量、溶栓率、脑卒中严重程度以及从脑卒中发病到住院的时间等方面的差异。
我们观察到脑卒中代码数量和接受再灌注治疗的患者数量没有明显变化（p = 0.669 和 0.415）。脑卒中发病到住院的中位数时间（p = 0.581）或国立卫生研究院脑卒中量表（NIHSS）评分（p = 0.055）均无差异。在 COVID-19 期间，从决策到开始治疗的时间明显缩短（中位数 5 分钟 [IQR 3-8]，p < 0.016），但其他时间没有明显变化。
本研究表明，TS 可适应 COVID-19 等极端情况，并且建立便于患者获得高质量治疗的网络至关重要。
