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Tytuł pozycji:

Clinician's Perception of Practice Changes for Stroke During the COVID-19 Pandemic.

Tytuł:
Clinician's Perception of Practice Changes for Stroke During the COVID-19 Pandemic.
Autorzy:
Kamdar HA; Department of Neurology, The Ohio State University, Columbus, Ohio USA.
Senay B; Department of Neurology, The Ohio State University, Columbus, Ohio USA.
Mainali S; Department of Neurology, The Ohio State University, Columbus, Ohio USA.
Lee V; Department of Neurology, The Ohio State University, Columbus, Ohio USA.
Gulati DK; Department of Neurology, The Ohio State University, Columbus, Ohio USA.
Greene-Chandos D; Department of Neurology, University of New Mexico, Albuquerque, New Mexico USA.
Hinduja A; Department of Neurology, The Ohio State University, Columbus, Ohio USA.
Strohm T; Department of Neurology, The Ohio State University, Columbus, Ohio USA. Electronic address: .
Źródło:
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2020 Oct; Vol. 29 (10), pp. 105179. Date of Electronic Publication: 2020 Jul 22.
Typ publikacji:
Journal Article; Observational Study
Język:
English
Imprint Name(s):
Publication: Philadelphia, PA : Saunders
Original Publication: New York, NY : Demos Publications, [1991-
MeSH Terms:
Attitude of Health Personnel*
Health Knowledge, Attitudes, Practice*
Coronavirus Infections/*therapy
Delivery of Health Care, Integrated/*trends
Infection Control/*trends
Pneumonia, Viral/*therapy
Practice Patterns, Physicians'/*trends
Stroke/*therapy
Betacoronavirus/pathogenicity ; COVID-19 ; Clinical Decision-Making ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/virology ; Cross-Sectional Studies ; Eligibility Determination/trends ; Health Care Surveys ; Host-Pathogen Interactions ; Humans ; Occupational Exposure/prevention & control ; Pandemics ; Patient Admission/trends ; Patient Transfer/trends ; Personal Protective Equipment/trends ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/virology ; Policy Making ; SARS-CoV-2 ; Stroke/diagnosis ; Stroke/epidemiology ; Stroke/virology ; Telemedicine/trends ; Time Factors ; United States/epidemiology
References:
Neurology. 2020 Jul 21;95(3):124-133. (PMID: 32385186)
BMC Health Serv Res. 2017 Jul 11;17(Suppl 1):457. (PMID: 28722550)
Eur Neurol. 2020;83(2):213-215. (PMID: 32289789)
Stroke. 2020 Jun;51(6):1902-1909. (PMID: 32352910)
J Neurosurg Anesthesiol. 2020 Jul;32(3):193-201. (PMID: 32282614)
Neurology. 2020 May 19;94(20):886-891. (PMID: 32253352)
J Clin Neurosci. 2020 Jul;77:13-16. (PMID: 32417124)
N Engl J Med. 2020 Jul 23;383(4):400-401. (PMID: 32383831)
Stroke. 2020 Jun;51(6):1891-1895. (PMID: 32233980)
Circ Cardiovasc Qual Outcomes. 2020 Apr;13(4):e006631. (PMID: 32182131)
Stroke. 2020 Jun;51(6):1896-1901. (PMID: 32347790)
J Neurointerv Surg. 2020 Jun;12(6):539-541. (PMID: 32295835)
Stroke. 2017 Jan;48(1):e3-e25. (PMID: 27811332)
Stroke. 2012 Jul;43(7):1858-64. (PMID: 22588262)
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Stroke. 2020 Jul;51(7):2012-2017. (PMID: 32432994)
Contributed Indexing:
Keywords: Acute Ischemic Stroke; COVID-19; Quality and Outcomes; Stroke management
Entry Date(s):
Date Created: 20200911 Date Completed: 20200916 Latest Revision: 20201218
Update Code:
20240105
PubMed Central ID:
PMC7375301
DOI:
10.1016/j.jstrokecerebrovasdis.2020.105179
PMID:
32912564
Czasopismo naukowe
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, P = 0.047, 95% CI: 1.004-1.748), change in eligibility criteria for IV-tPA or mechanical thrombectomy (MT) (OR 3.146, P = 0.052, 95% CI: 0.988-10.017), and modified admission practices for post IV-tPA or MT patients (OR 2.141, P = 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.
(Copyright © 2020 Elsevier Inc. All rights reserved.)

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