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Decreased Stroke Presentation Rates at a Comprehensive Stroke Center during COVID-19
Dar Dowlatshahi1, Grant Stotts1, Aline Bourgoin2
1Department of Medicine (Neurology), University of Ottawa Brain & Mind Institute and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Insights
During COVID-19, stroke care in Ontario saw significant reductions in prevention clinic referrals, code strokes, and telestroke activations. Acute stroke treatment rates remained stable, indicating a pandemic impact on stroke service accessibility.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic significantly disrupted healthcare systems globally.
- Stroke care delivery faced unprecedented challenges, including resource reallocation and patient hesitancy.
Purpose of the Study:
- To evaluate the impact of the COVID-19 pandemic on the continuum of stroke care delivery.
- To analyze changes in stroke prevention, acute treatment, and telestroke utilization during the pandemic.
Main Methods:
- Retrospective review of stroke care data from February to April, 2017-2020.
- Analysis included prevention clinic referrals, code strokes, thrombolysis, endovascular thrombectomies, and telestroke activations.
- Comparison of April 2020 data against the average of the preceding three years (2017-2019).
Main Results:
- April 2020 showed a 28% decrease in prevention clinic referrals, a 32% decrease in code strokes, and a 26% decrease in telestroke activations compared to prior years.
- Rates of thrombolysis and endovascular thrombectomy remained consistent.
- A notable reduction in overall patient access to stroke services was observed.
Conclusions:
- The COVID-19 pandemic led to a significant decrease in stroke prevention and acute care access in Ontario.
- While acute interventions like thrombolysis and thrombectomy were maintained, fewer patients accessed the full spectrum of stroke care.
- Findings highlight the need for strategies to ensure continuity of stroke care during public health crises.
Abstract:
We reviewed stroke care delivery during the COVID-19 pandemic at our stroke center and provincial telestroke system. We counted referrals to our prevention clinic, code strokes, thrombolysis, endovascular thrombectomies, and activations of a provincial telestroke system from February to April of 2017-2020. In April 2020, there was 28% reduction in prevention clinic referrals, 32% reduction in code strokes, and 26% reduction in telestroke activations compared to prior years. Thrombolysis and endovascular thrombectomy rates remained constant. Fewer patients received stroke services across the spectrum from prevention, acute care to telestroke care in Ontario, Canada, during the COVID-19 pandemic.
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