Premium
Impact of the first wave of COVID‐19 on stroke admissions across three tertiary hospitals in Brisbane
Author(s) -
Roizman Michael,
Hartel Gunter,
Wong Andrew,
Brown Helen,
Muller Claire,
Gillinder Lisa
Publication year - 2022
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.15827
Subject(s) - medicine , stroke (engine) , thrombolysis , emergency department , retrospective cohort study , covid-19 , pandemic , emergency medicine , presentation (obstetrics) , cohort , cohort study , observational study , acute stroke , pediatrics , surgery , myocardial infarction , disease , mechanical engineering , psychiatry , infectious disease (medical specialty) , engineering
Background COVID‐19 has caused a global shift in healthcare‐seeking behaviour; however, presentation rates with serious conditions, such as stroke in low COVID‐19‐prevalence cities, has received less attention. Aims To determine if there was a significant reduction in stroke admissions, delivery of acute reperfusion therapies, or increased delays to presentation during the first wave of the COVID‐19 pandemic. Methods A multicentre, retrospective, observational cohort study was performed across three tertiary hospitals in Brisbane, Australia. Cases were identified using ICD‐10 codes and then individually reviewed for eligibility using prespecified inclusion and exclusion criteria. All metrics were compared over 3 months from 1 March to 31 May 2020 with two corresponding 3‐month periods in 2018 and 2019. Results There was a mean of 2.15 (95% CI 1.87–2.48) stroke admissions per day in the examined pandemic months compared with 2.13 (95% CI 1.85–2.45) and 2.26 (95% CI 1.97–2.59) in March to May 2018 and 2019 respectively, with no significant difference found ( P = 0.81). There was also no difference in rates of intravenous thrombolysis ( P = 0.82), endovascular thrombectomy ( P = 0.93) and time from last known well to presentation ( P = 0.54). Conversely, daily emergency department presentations (including non‐stroke presentations) significantly reduced ( P < 0.0001). Conclusions During the early months of the COVID‐19 pandemic there was no significant reduction in stroke presentations, use of acute reperfusion therapies or delays to presentation, despite a reduction in ED presentations for any cause. Our results differ from the global experience, with possible explanations, including differences in public health messaging and healthcare infrastructure.