Slump in Hospital Admissions for Stroke, a Fact of an Uncertain Nature That Requires Explanation

José M Ramírez-Moreno1,2,3,4, Juan Carlos Portilla-Cuenca5, Roshan Hariramani-Ramchandani1

  • 1Department of Neurology, University Hospital of Badajoz, 06080 Badajoz, Spain.

Brain Sciences
|January 16, 2021
PubMed

Insights

The COVID-19 pandemic significantly reduced stroke care, including fewer stroke code activations and reperfusion therapies, despite increased emergency calls. This highlights a critical public health crisis impacting time-sensitive stroke treatment.

Area of Science:

  • Neurology
  • Public Health
  • Epidemiology

Background:

  • The COVID-19 pandemic has disrupted healthcare, particularly for time-sensitive conditions like stroke.
  • Stroke units experienced collateral effects on patient care during the pandemic.
  • This study compares stroke unit activity in 2019 and 2020, focusing on the state of alarm period.

Purpose of the Study:

  • To compare healthcare activity in two stroke units before and during the COVID-19 pandemic.
  • To analyze the impact of the state of alarm on stroke care metrics.
  • To investigate changes in stroke admissions, treatments, and mortality.

Main Methods:

  • Comparative analysis of stroke unit data from 2019 and 2020.
  • Data grouped by calendar weeks, with a focus on the 10-week state of alarm period.
  • Statistical analysis including Poisson regression to assess changes in key indicators.

Main Results:

  • Emergency calls increased by 318% during the state of alarm.
  • Stroke code activations decreased (p=0.04), as did overall stroke unit activity.
  • Hospitalizations for transient ischemic attacks dropped by 35.7%, reperfusion therapies by 37.5%, and telestroke activity by 28.9%, with increased hospital mortality.

Conclusions:

  • The COVID-19 pandemic led to a significant decline in stroke care activity and worse patient outcomes.
  • The prolonged pandemic poses a substantial public health challenge for stroke management.
  • Further research is needed to understand the complex factors contributing to reduced stroke admissions and their negative consequences.