Stroke patterns and outcomes during the second wave of COVID-19 pandemic: a cross-sectional study

Bikram P Gajurel1, Subarna Giri2, Parishma Tamrakar3

  • 1Department of Neurology, Tribhuvan University Teaching Hospital.

Insights

The COVID-19 pandemic caused delays in stroke treatment, with arranging vehicles being a common prehospital delay. Hospital stay duration and NIHSS score predict stroke outcomes.

Area of Science:

  • Neurology
  • Public Health
  • Epidemiology

Background:

  • The COVID-19 pandemic significantly impacted stroke care, affecting patient admissions, treatment timeliness, and quality metrics.
  • Understanding these impacts is crucial for optimizing stroke management strategies during health crises.

Purpose of the Study:

  • To investigate stroke types, treatment delays, and outcome predictors during the second wave of the COVID-19 pandemic.
  • To analyze prehospital delays and their impact on patient outcomes.

Main Methods:

  • A single-centered prospective cross-sectional study conducted from May to November 2021.
  • Inclusion of 64 patients with stroke, collecting data on demographics, stroke types, outcomes, and prehospital delays.
  • Binary logistic regression used to identify predictors of 3-month outcomes.

Main Results:

  • Ischemic stroke was more prevalent than hemorrhagic stroke.
  • The median emergency room arrival time was 24 hours, with vehicle arrangement delays being the most common prehospital delay.
  • Median hospital stay duration and baseline National Institute of Health Stroke Scale (NIHSS) score were significant predictors of good 3-month outcomes.

Conclusions:

  • Addressing factors contributing to delayed hospital transfer and treatment initiation is essential.
  • Patient prognosis counseling can be enhanced by considering NIHSS scores and hospital stay duration.
  • Developing mechanisms to reduce prehospital delays at both ground and policy levels is recommended.

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