PDF(Sci-hub)
Abstract：
BACKGROUND: The COVID-19 pandemic has strained the healthcare systems across the world but its impact on acute stroke care is just being elucidated. We hypothesized a major global impact of COVID-19 not only on stroke volumes but also on various aspects of thrombectomy systems.
OBJECTIVE: We conducted a convenience electronic survey with a 21-item questionnaire aimed to identify the changes in stroke admission volumes and thrombectomy treatment practices seen during a specified time period of the COVID-19 pandemic.
METHODS: The survey was designed using Qualtrics software and sent to stroke and neuro-interventional physicians around the world who are part of the Global Executive Committee (GEC) of Mission Thrombectomy 2020, a global coalition under the aegis of Society of Vascular and Interventional Neurology, between April 5th and May 15th, 2020.
RESULTS: There were 113 responses to the survey across 25 countries with a response rate of 31% among the GEC members. Globally there was a median 33% decrease in stroke admissions and a 25% decrease in mechanical thrombectomy (MT) procedures during the COVID-19 pandemic period until May 15th, 2020 compared to pre-pandemic months. The intubation policy for MT procedures during the pandemic was highly variable across participating centers: 44% preferred intubating all patients, including 25% of centers that changed their policy to preferred-intubation (PI) from preferred non-intubation (PNI). On the other hand, 56% centers preferred not intubating patients undergoing MT, which included 27% centers that changed their policy from PI to PNI. There was no significant difference in rate of COVID-19 infection between PI versus PNI centers (p=0.60) or if intubation policy was changed in either direction (p=1.00). Low-volume (<10 stroke/month) compared with high-volume stroke centers (>20 strokes/month) were less likely to have neurointerventional suite specific written personal protective equipment protocols (74% vs 88%) and if present, these centers were more likely to report them to be inadequate (58% vs 92%).
CONCLUSIONS: Our data provides a comprehensive snapshot of the impact on acute stroke care observed worldwide during the pandemic. Overall, respondents reported decreased stroke admissions as well as decreased cases of MT with no clear preponderance in intubation policy during MT.
UNASSIGNED: The corresponding author will consider requests for sharing survey data. The study was exempt from institutional review board approval as it did not involve patient level data.
OBJECTIVE: We conducted a convenience electronic survey with a 21-item questionnaire aimed to identify the changes in stroke admission volumes and thrombectomy treatment practices seen during a specified time period of the COVID-19 pandemic.
METHODS: The survey was designed using Qualtrics software and sent to stroke and neuro-interventional physicians around the world who are part of the Global Executive Committee (GEC) of Mission Thrombectomy 2020, a global coalition under the aegis of Society of Vascular and Interventional Neurology, between April 5th and May 15th, 2020.
RESULTS: There were 113 responses to the survey across 25 countries with a response rate of 31% among the GEC members. Globally there was a median 33% decrease in stroke admissions and a 25% decrease in mechanical thrombectomy (MT) procedures during the COVID-19 pandemic period until May 15th, 2020 compared to pre-pandemic months. The intubation policy for MT procedures during the pandemic was highly variable across participating centers: 44% preferred intubating all patients, including 25% of centers that changed their policy to preferred-intubation (PI) from preferred non-intubation (PNI). On the other hand, 56% centers preferred not intubating patients undergoing MT, which included 27% centers that changed their policy from PI to PNI. There was no significant difference in rate of COVID-19 infection between PI versus PNI centers (p=0.60) or if intubation policy was changed in either direction (p=1.00). Low-volume (<10 stroke/month) compared with high-volume stroke centers (>20 strokes/month) were less likely to have neurointerventional suite specific written personal protective equipment protocols (74% vs 88%) and if present, these centers were more likely to report them to be inadequate (58% vs 92%).
CONCLUSIONS: Our data provides a comprehensive snapshot of the impact on acute stroke care observed worldwide during the pandemic. Overall, respondents reported decreased stroke admissions as well as decreased cases of MT with no clear preponderance in intubation policy during MT.
UNASSIGNED: The corresponding author will consider requests for sharing survey data. The study was exempt from institutional review board approval as it did not involve patient level data.
摘要：
背景：COVID-19大流行已经使世界各地的医疗保健系统紧张，但其对急性中风护理的影响刚刚被阐明。我们假设COVID-19不仅对每搏量，而且对血栓切除系统的各个方面都有重大的全球影响。
目的：我们使用21项问卷进行了一项便利的电子调查，旨在确定在COVID-19大流行的特定时间段内，卒中入院量和血栓切除术治疗实践的变化。
方法：该调查是使用Qualtrics软件进行设计的，并发送给世界各地的中风和神经介入医生，他们是2020年Mission血栓切除术全球执行委员会（GEC）的一部分，该委员会是血管和介入神经病学会的全球联盟。4月5日至5月15日,2020年。
结果：共有来自25个国家的113份调查答复，GEC成员的答复率为31%。在截至5月15日的COVID-19大流行期间，全球卒中入院率中位数下降33%，机械血栓切除术(MT)下降25%，2020年与大流行前几个月相比。大流行期间MT手术的插管政策在参与中心之间差异很大：44％的患者首选插管，包括25%的中心将其政策从首选非插管(PNI)更改为首选插管(PI)。另一方面,56%的中心首选不插管接受MT的患者，其中包括27%的中心将政策从PI更改为PNI。PI中心与PNI中心之间的COVID-19感染率没有显着差异（p=0.60），或者在任一方向上改变了插管政策（p=1.00）。与高容量卒中中心(>20次/月)相比，低容量(<10次/月)不太可能有神经介入套件特定的书面个人防护设备方案(74%vs88%)，如果存在，这些中心更有可能报告它们不足(58%vs92%).
结论：我们的数据提供了全球大流行期间对急性卒中护理的影响的全面快照。总的来说,受访者报告卒中入院人数减少,MT病例减少,但MT期间插管政策没有明显优势.
UNASSIGNED：通讯作者将考虑共享调查数据的请求。该研究免于机构审查委员会的批准，因为它不涉及患者水平的数据。
目的：我们使用21项问卷进行了一项便利的电子调查，旨在确定在COVID-19大流行的特定时间段内，卒中入院量和血栓切除术治疗实践的变化。
方法：该调查是使用Qualtrics软件进行设计的，并发送给世界各地的中风和神经介入医生，他们是2020年Mission血栓切除术全球执行委员会（GEC）的一部分，该委员会是血管和介入神经病学会的全球联盟。4月5日至5月15日,2020年。
结果：共有来自25个国家的113份调查答复，GEC成员的答复率为31%。在截至5月15日的COVID-19大流行期间，全球卒中入院率中位数下降33%，机械血栓切除术(MT)下降25%，2020年与大流行前几个月相比。大流行期间MT手术的插管政策在参与中心之间差异很大：44％的患者首选插管，包括25%的中心将其政策从首选非插管(PNI)更改为首选插管(PI)。另一方面,56%的中心首选不插管接受MT的患者，其中包括27%的中心将政策从PI更改为PNI。PI中心与PNI中心之间的COVID-19感染率没有显着差异（p=0.60），或者在任一方向上改变了插管政策（p=1.00）。与高容量卒中中心(>20次/月)相比，低容量(<10次/月)不太可能有神经介入套件特定的书面个人防护设备方案(74%vs88%)，如果存在，这些中心更有可能报告它们不足(58%vs92%).
结论：我们的数据提供了全球大流行期间对急性卒中护理的影响的全面快照。总的来说,受访者报告卒中入院人数减少,MT病例减少,但MT期间插管政策没有明显优势.
UNASSIGNED：通讯作者将考虑共享调查数据的请求。该研究免于机构审查委员会的批准，因为它不涉及患者水平的数据。
