The COVID-19 pandemic is an ongoing pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the onset of the pandemic, several groups have reported a decreased number of patients admitted to hospital with acute ischemic stroke.However, up to now, only a few studies have attempted to quantify the impact of the COVID-19 outbreak on the incidence and treatment rates of acute stroke [1-8], and none have included data from an entire country during the COVID-19 pandemic. The aim of the present study was to perform a detailed analysis of variations in the acute stroke pathway in Slovakia during 2 months of the outbreak, using the same time period from 2019 and 2 months of 2020 before the outbreak as comparators. This was possible thanks to the
Introduction: The aim of our study was to determine whether the severity of the COVID-19 pandemic affected the quality of acute care of stroke. Methods: Data from the stroke register at the National Health Information Centre were analysed. Clinical data from two time periods (the first wave: March–April 2020; the second wave: October–November 2020) were compared using an independent sample t-test and the Wilcoxon-Mann-Whitney two sample rank-sum test. Results: The total number of patients admitted with stroke during the second wave of COVID-19 was 1848, versus 1698 in the first wave. The proportion of patients treated by IVT was similar in both waves (275 (20.7%) vs 333 (22.1%), p = 1, difference in location: −0,0003, 95% CI: −5.0 to 5.95). We found no difference in time from the onset of symptoms to treatment (median = 130 min in both waves, p = 0.52, difference in location: 3.99, 95% CI: −6.0 to 14.0), nor in the door-to-needle time (median = 29 vs 30 min, p = 0.08, difference in location: −2.99, 95% CI: −5.0 to 0.008) between the first and the second waves of the pandemic. We found no difference in NIHSS (median = 3 vs 4, p = 0.51, difference in location: 0.00007, 95% CI: −0.9 to 0.000006) and mRS (median = 3 in both waves, p = 0.60, difference in location: −0.00004, 95% CI: −0.00004 to 0.00003) at discharge from hospital between the two periods. Conclusion: The severity of the COVID-19 outbreak did not affect the quality of acute stroke care in Slovakia.
This study analysed the implementation of official European Society of Cardiology (ESC) guidelines for the management of ST elevated myocardial infarction (STEMI) patients. Initiatives were aimed at the education of both healthcare professionals and inhabitants. Changes in clinical practice and clinical outputs were analysed using data acquired from the SLOVak registry of Acute Coronary Syndromes (SLOVAKS). From 2007 to 2008 positive changes were noticed at every level of the 'life chain'. The proportion of patients treated by primary percutaneous coronary intervention (PCI) and by early reperfusion rose significantly. Total ischaemic time was shortened by 12 min in patients treated by thrombolysis and by 26 min in patients treated by PCI. In-hospital lethality for STEMI decreased significantly. The weakest point in the management of STEMI patients in Slovakia was the still-significant time loss incurred by patients themselves. Targeted initiatives aimed at implementing official ESC guidelines can significantly improve clinical outcomes in a relatively short period of time.
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