COVID didn’t have an effect on stroke affected person care high quality or outcomes in US’s largest healthcare system

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In one of many first research to research the general high quality of care and outcomes of stroke look after non-COVID-19 hospitalized sufferers throughout the pandemic from a nationwide U.S. perspective, researchers from the U.S. Department of Veterans Affairs (VA), Regenstrief Institute and Monash University assessed sufferers with strokes and transient ischemic assaults (usually known as mini-strokes or TIAs) in 128 hospitals throughout the U.S. within the VA’s well being system, the nation’s largest built-in healthcare system. The researchers report no decline in total high quality of care nor outcomes (after danger adjustment) when evaluating sufferers with stroke and mini-strokes from previous to the pandemic [March to September 2019] to the identical months throughout the pandemic [March to September 2020].

As with different non-COVID-19 circumstances, the variety of hospitalizations for strokes and mini-strokes was decrease throughout the pandemic than earlier than COVID-19; roughly 30 p.c decrease for mini-strokes and 19 p.c decrease for strokes.

The researchers used seven standardized measures to find out that total high quality of look after stroke and mini-stroke didn’t diminish in VA amenities throughout the pandemic. They discovered that, importantly, the usage of statin drugs continued to extend throughout 2020—particularly amongst sufferers with stroke—a development that had been evident for a number of years previous to the pandemic. However, sufferers with stroke or mini-stroke had far fewer major care visits, delaying or deferring care throughout the pandemic.

During the pandemic roughly 40 p.c of stroke sufferers didn’t have a blood strain measurement whereas solely 10 p.c of stroke sufferers pre-pandemic didn’t have a blood strain measurement. Missing blood strain checks was related to a six-fold improve in short-term mortality and a three-fold improve in long-term mortality, in accordance with VA and Regenstrief Research Scientist Dawn Bravata, M.D., an Indiana University School of Medicine school member, who led the research. She notes {that a} strong relationship between rising blood strain and stroke danger has lengthy been recognized to exist. The researchers discovered that blood strain, when measured throughout the pandemic, was not as properly managed as throughout the pre-pandemic interval.

The research additionally discovered that demise charges of stroke or mini-stroke sufferers in VA hospitals weren’t statistically totally different after danger adjustment throughout the pre-pandemic and pandemic time intervals.

“As a healthcare system that is responsible for and tracks patients after they are discharged from the hospital, the VA is well suited to conduct this type of analysis and do the follow-up indicated—for example, helping patients control blood pressure after a stroke or ministroke,” mentioned Dr. Bravata. “Given the widespread phenomena that people received less healthcare during the pandemic, we would expect the same decrease in primary care visits in non-VA settings. As patients return to primary care, post-stroke checkups and blood pressure control hopefully can be prioritized.”

With few exceptions, stroke and mini-stroke affected person traits had been comparable between 2019 (pre-pandemic) and 2020. The researchers discovered that throughout the pandemic, a barely better proportion of sufferers got here to the hospital on account of a stroke, quite than as a consequence of a mini-stroke (69 p.c versus 66 p.c). Dr. Bravata says that people with transient signs of mini-strokes could have hesitated to hunt medical consideration throughout the pandemic.

The research evaluated look after sufferers with stroke or mini-stroke from typical causes and didn’t embody sufferers who had been admitted to the hospital for COVID-19 after which had a stroke or mini-stroke. Fewer than 2 p.c (72 people) of these admitted to the 128 VA hospitals with stroke or mini-stroke from March to September 2020 concurrently had or subsequently developed COVID-19.

The analysis is revealed within the Journal of Stroke and Cerebrovascular Diseases.


Stroke hospital visits down markedly in first 12 months of COVID-19 pandemic


More info:
Laura J. Myers et al, Quality of Care and Outcomes for Patients with Acute Ischemic Stroke and Transient Ischemic Attack During the COVID-19 Pandemic, Journal of Stroke and Cerebrovascular Diseases (2022). DOI: 10.1016/j.jstrokecerebrovasdis.2022.106455

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Regenstrief Institute

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COVID didn’t have an effect on stroke affected person care high quality or outcomes in US’s largest healthcare system (2022, June 22)
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