Clinician's Perception of Practice Changes for Stroke During the COVID-19 Pandemic.
J Stroke Cerebrovasc Dis
; 29(10): 105179, 2020 Oct.
Article
en En
| MEDLINE
| ID: mdl-32912564
ABSTRACT
BACKGROUND:
Approach to acute cerebrovascular disease management has evolved in the past few months to accommodate the rising needs of the 2019 novel coronavirus (COVID-19) pandemic. In this study, we investigated the changes in practices and policies related to stroke care through an online survey.METHODS:
A 12 question, cross-sectional survey targeting practitioners involved in acute stroke care in the US was distributed electronically through national society surveys, social media and personal communication.RESULTS:
Respondants from 39 states completed 206 surveys with the majority (82.5%) from comprehensive stroke centers. Approximately half stated some change in transport practices with 14 (7%) reporting significant reduction in transfers. Common strategies to limit healthcare provider exposure included using personal protective equipment (PPE) for all patients (127; 63.5%) as well as limiting the number of practitioners in the room (129; 64.5%). Most respondents (81%) noted an overall decrease in stroke volume. Many (34%) felt that the outcome or care of acute stroke patients had been impacted by COVID-19. This was associated with a change in hospital transport guidelines (OR 1.325, Pâ¯=â¯0.047, 95% CI 1.004-1.748), change in eligibility criteria for IV-tPA or mechanical thrombectomy (MT) (OR 3.146, Pâ¯=â¯0.052, 95% CI 0.988-10.017), and modified admission practices for post IV-tPA or MT patients (OR 2.141, Pâ¯=â¯0.023, 95% CI 1.110-4.132).CONCLUSION:
Our study highlights a change in practices and polices related to acute stroke management in response to COVID-19 which are variable among institutions. There is also a reported reduction in stroke volume across hospitals. Amongst these changes, updates in hospital transport guidelines and practices related to IV-tPA and MT may affect the perceived care and outcome of acute stroke patients.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Neumonía Viral
/
Pautas de la Práctica en Medicina
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Actitud del Personal de Salud
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Conocimientos, Actitudes y Práctica en Salud
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Control de Infecciones
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Infecciones por Coronavirus
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Prestación Integrada de Atención de Salud
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Accidente Cerebrovascular
Tipo de estudio:
Diagnostic_studies
/
Guideline
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Stroke Cerebrovasc Dis
Asunto de la revista:
ANGIOLOGIA
/
CEREBRO
Año:
2020
Tipo del documento:
Article