Repositorio Dspace

Stroke Care Trends During COVID-19 Pandemic in Zanjan Province, Iran. From the CASCADE Initiative: Statistical Analysis Plan and Preliminary Results

Mostrar el registro sencillo del ítem

dc.contributor.author Ghoreishi, Abdoreza
dc.contributor.author Arsang-Jang, Shahram
dc.contributor.author Sabaa-Ayoun, Ziad
dc.contributor.author Yassi, Nawaf
dc.contributor.author Sylaja, P.N.
dc.contributor.author Akbari, Yama
dc.contributor.author Divani, Afshin A.
dc.contributor.author Biller, Jose
dc.contributor.author Phan, Thanh
dc.contributor.author Steinwender, Sandy
dc.contributor.author Silver, Brian
dc.contributor.author Zand, Ramin
dc.contributor.author Bin Basri, Hamidon
dc.contributor.author Iqbal, Omer M.
dc.contributor.author Ranta, Annemarei
dc.contributor.author Ruland, Sean
dc.contributor.author Macri, Elizabeth
dc.contributor.author Ma, Henry
dc.contributor.author Nguyen, Thanh N.
dc.contributor.author Abootalebi, Shahram
dc.contributor.author Gupta, Animesh
dc.contributor.author Alet, Matías Javier
dc.contributor.author Lattanzi, Simona
dc.contributor.author Desai, Masoom
dc.contributor.author Gagliardi, Rubens J.
dc.contributor.author Girotra, Tarun
dc.contributor.author Inoue, Manabu
dc.contributor.author Yoshimoto, Takeshi
dc.contributor.author Isaac, Cristian Flavo
dc.contributor.author Mayer, Stephan A.
dc.contributor.author Morovatdar, Negar
dc.contributor.author Nilanont, Yongchai
dc.contributor.author Nobleza, Christa O'Hana S.
dc.contributor.author Saber, Hamidreza
dc.contributor.author Kamenova, Saltanat
dc.contributor.author Kondybayeva, Aida
dc.contributor.author Krupinski, Jerzy
dc.contributor.author Siegler, James E.
dc.contributor.author Stranges, Saverio
dc.contributor.author Torbey, Michel T.
dc.contributor.author Yorio, Diana
dc.contributor.author Zurrú, María Cristina
dc.contributor.author Rubinos, Clio Aracelli
dc.contributor.author Bavarsad Shahripour, Reza
dc.contributor.author Borhani-Haghighi, Afshin
dc.contributor.author Di Napoli, Mario
dc.contributor.author Azarpazhooh, M Reza
dc.date.accessioned 2021-04-20T15:17:53Z
dc.date.available 2021-04-20T15:17:53Z
dc.date.issued 2020-12
dc.identifier.citation Ghoreishi, A., Arsang-Jang, S., Sabaa-Ayoun, Z., Yassi, N., Sylaja, P.N., Akbari, Y., Divani, A.A., Biller, J., Phan, T., Steinwender, S., Silver, B., Zand, R., Basri, H.B., Iqbal, O.M., Ranta, A., Ruland, S., Macri, E., Ma, H., Nguyen, T.N., Abootalebi, S., Gupta, A., Alet, M., Lattanzi, S., Desai, M., Gagliardi, R.J., Girotra, T., Inoue, M., Yoshimoto, T., Isaac, C.F., Mayer, S.A., Morovatdar, N., Nilanont, Y., Nobleza, C.O.S., Saber, H., Kamenova, S., Kondybayeva, A., Krupinski, J., Siegler, J.E., Stranges, S., Torbey, M.T., Yorio, D., Zurrú, M.C., Rubinos, C.A., Shahripour, R.B., Borhani-Haghighi, A., Napoli, M.D., Azarpazhooh, M.R., 2020. Stroke Care Trends During COVID-19 Pandemic in Zanjan Province, Iran. From the CASCADE Initiative: Statistical Analysis Plan and Preliminary Results. J Stroke Cerebrovasc Dis 29, 105321. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105321 es_ES
dc.identifier.uri https://repositorio.fleni.org.ar/xmlui/handle/123456789/418
dc.identifier.uri https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105321
dc.description.abstract Background: The emergence of the COVID-19 pandemic has significantly impacted global healthcare systems and this may affect stroke care and outcomes. This study examines the changes in stroke epidemiology and care during the COVID-19 pandemic in Zanjan Province, Iran. Methods: This study is part of the CASCADE international initiative. From February 18, 2019, to July 18, 2020, we followed ischemic and hemorrhagic stroke hospitalization rates and outcomes in Valiasr Hospital, Zanjan, Iran. We used a Bayesian hierarchical model and an interrupted time series analysis (ITS) to identify changes in stroke hospitalization rate, baseline stroke severity [measured by the National Institutes of Health Stroke Scale (NIHSS)], disability [measured by the modified Rankin Scale (mRS)], presentation time (last seen normal to hospital presentation), thrombolytic therapy rate, median door-to-needle time, length of hospital stay, and in-hospital mortality. We compared in-hospital mortality between study periods using Cox-regression model. Results: During the study period, 1,026 stroke patients were hospitalized. Stroke hospitalization rates per 100,000 population decreased from 68.09 before the pandemic to 44.50 during the pandemic, with a significant decline in both Bayesian [Beta: -1.034; Standard Error (SE): 0.22, 95% CrI: -1.48, -0.59] and ITS analysis (estimate: -1.03, SE = 0.24, p < 0.0001). Furthermore, we observed lower admission rates for patients with mild (NIHSS < 5) ischemic stroke (p < 0.0001). Although, the presentation time and door-to-needle time did not change during the pandemic, a lower proportion of patients received thrombolysis (-10.1%; p = 0.004). We did not see significant changes in admission rate to the stroke unit and in-hospital mortality rate; however, disability at discharge increased (p < 0.0001). Conclusion: In Zanjan, Iran, the COVID-19 pandemic has significantly impacted stroke outcomes and altered the delivery of stroke care. Observed lower admission rates for milder stroke may possibly be due to fear of exposure related to COVID-19. The decrease in patients treated with thrombolysis and the increased disability at discharge may indicate changes in the delivery of stroke care and increased pressure on existing stroke acute and subacute services. The results of this research will contribute to a similar analysis of the larger CASCADE dataset in order to confirm findings at a global scale and improve measures to ensure the best quality of care for stroke patients during the COVID-19 pandemic. es_ES
dc.language.iso eng es_ES
dc.publisher Demos Publications es_ES
dc.rights info:eu-repo/semantics/openAccess
dc.rights.uri https://creativecommons.org/licenses/by/2.5/ar/
dc.subject Coronavirus Infections es_ES
dc.subject Infecciones por Coronavirus es_ES
dc.subject Accidente Cerebrovascular es_ES
dc.subject Stroke es_ES
dc.subject Irán
dc.subject Treatment Outcome
dc.subject Resultado del Tratamiento
dc.title Stroke Care Trends During COVID-19 Pandemic in Zanjan Province, Iran. From the CASCADE Initiative: Statistical Analysis Plan and Preliminary Results es_ES
dc.type info:eu-repo/semantics/article es_ES
dc.type info:eu-repo/semantics/publishedVersion
dc.description.fil Fil: Alet, Matías Javier. Fleni. Departamento de Neurología. Centro Integral de Neurología Vascular; Argentina.
dc.description.fil Fil: Ghoreishi, Abdoreza. Zanjan University of Medical Sciences. School of Medicine. Vali-e-Asr hospital. Department of Neurology and Stroke Unit. Stroke Research Group; Irán.
dc.description.fil Fil: Arsang-Jang, Shahram. Zanjan University of Medical Sciences. School of Medicine. Department of Biostatistics and Epidemiology; Irán.
dc.description.fil Fil: Sabaa-Ayoun, Ziad. Western University. Robarts Research Institute. Stroke Prevention and Atherosclerosis Research Centre; Canadá. Western University. Schulich School of Medicine and Dentistry; Canadá.
dc.description.fil Fil: Yassi, Nawaf. University of Melbourne. Melbourne Brain Centre at The Royal Melbourne Hospital. Department of Medicine and Neurology; Australia. The Walter and Eliza Hall Institute of Medical Research. Population Health and Immunity Division; Australia.
dc.description.fil Fil: Sylaja, P N. Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST). Comprehensive Stroke Care Program; India.
dc.description.fil Fil: Akbari, Yama. University of California. Beckman Laser Institute & Medical Clinic. Departments of Neurology, Neurological Surgery, and Anatomy & Neurobiology; Estados Unidos.
dc.description.fil Fil: Divani, Afshin A. University of New Mexico. School of Medicine. Department of Neurology; México.
dc.description.fil Fil: Biller, Jose. Loyola University. Stritch School of Medicine. Department of Neurology; Estados Unidos.
dc.description.fil Fil: Phan, Thanh. Monash University. School of Clinical Sciences. Department of Neurology, Monash Health and Department of Medicine; Australia.
dc.description.fil Fil: Steinwender, Sandy. Western University. Health Information Science; Canada. London Health Sciences. Southwestern Ontario Stroke Network. Regional Stroke Prevention; Canada.
dc.description.fil Fil: Silver, Brian. University of Massachusetts Medical School. Department of Neurology; Estados Unidos.
dc.description.fil Fil: Zand, Ramin. Geisinger Medical Center. Neuroscience Institute. Department of Neurology; Estados Unidos.
dc.description.fil Fil: Bin Basri, Hamidon. UPM. Faculty of Medicine and Health Sciences. Department of Medicine; Malasia.
dc.description.fil Fil: Iqbal, Omer M. Loyola University Stritch School of Medicine. Center for Translational Research & Education. Department of Pathology and Ophthalmology; Estados Unidos.
dc.description.fil Fil: Ranta, Annemarei. University of Otago and Wellington Hospital. Department of Medicine and Neurology; Nueva Zelanda.
dc.description.fil Fil: Ruland, Sean. Boston University School of Medicine. Boston Medical Center; Estados Unidos.
dc.description.fil Fil: Macri, Elizabeth. Loyola University. Stritch School of Medicine. Department of Neurology; Estados Unidos.
dc.description.fil Fil: Ma, Henry. Monash University. School of Clinical Sciences. Monash Health and Department of Medicine.Department of Neurology; Australia.
dc.description.fil Fil: Nguyen, Thanh N. Boston University School of Medicine. Boston Medical Center; Estados Unidos.
dc.description.fil Fil: Abootalebi, Shahram. Dalhousie University. Dr. Everett Chalmers Regional Hospital; Canadá.
dc.description.fil Fil: Gupta, Animesh. University of New Mexico. School of Medicine. Department of Neurology; México.
dc.relation.ispartofCOUNTRY Estados Unidos
dc.relation.ispartofCITY Nueva York
dc.relation.ispartofTITLE Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.
dc.relation.ispartofISSN 1532-8511
dc.type.snrd info:ar-repo/semantics/artículo es_ES


Ficheros en el ítem

Este ítem aparece en la(s) siguiente(s) colección(ones)

Mostrar el registro sencillo del ítem

info:eu-repo/semantics/openAccess Excepto si se señala otra cosa, la licencia del ítem se describe como info:eu-repo/semantics/openAccess

Buscar en DSpace


Listar

Mi cuenta

Estadísticas