Rapid outpatient transient ischemic attack clinic and stroke service activity during the SARS-CoV-2 pandemic: a multicenter time series analysis Article Swipe
Andy Lim
,
Peter M. Rothwell
,
Linxin Li
,
Shelagh B. Coutts
,
Michael D. Hill
,
Maria Guarino
,
Valentina Barone
,
Francesca Rondelli
,
Timothy Kleinig
,
Reid Cornell-Farrow
,
Martín Krause
,
Miriam Wronski
,
Shaloo Singhal
,
Henry Ma
,
Thanh G. Phan
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.3389/fneur.2024.1351769
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.3389/fneur.2024.1351769
Background and aim Rapid outpatient evaluation and treatment of TIA in structured clinics have been shown to reduce stroke recurrence. It is unclear whether short-term downtrends in TIA incidence and admissions have had enduring impact on TIA clinic activity. This study aims to measure the impact of the pandemic on hospitals with rapid TIA clinics. Methods Relevant services were identified by literature search and contacted. Three years of monthly data were requested – a baseline pre-COVID period (April 2018 to March 2020) and an intra-COVID period (April 2020 to March 2021). TIA presentations, ischemic stroke presentations, and reperfusion trends inclusive of IV thrombolysis (IVT) and endovascular thrombectomy (EVT) were recorded. Pandemic impact was measured with interrupted time series analysis, a segmented regression approach to test an effect of an intervention on a time-dependent outcome using a defined impact model. Results Six centers provided data for a total of 6,231 TIA and 13,191 ischemic stroke presentations from Australia (52.1%), Canada (35.0%), Italy (7.6%), and England (5.4%). TIA clinic volumes remained constant during the pandemic (2.9, 95% CI –1.8 to 7.6, p = 0.24), as did ischemic stroke (2.9, 95% CI –7.8 to 1.9, p = 0.25), IVT (−14.3, 95% CI −36.7, 6.1, p < 0.01), and EVT (0, 95% CI –16.9 to 16.9, p = 0.98) counts. Proportion of ischemic strokes requiring IVT decreased from 13.2 to 11.4% ( p < 0.05), but those requiring EVT did not change (16.0 to 16.7%, p = 0.33). Conclusion This suggests that the pandemic has not had an enduring effect on TIA clinic or stroke service activity for these centers. Furthermore, the disproportionate decrease in IVT suggests that patients may be presenting outside the IVT window during the pandemic – delays in seeking treatment in this group could be the target for public health intervention.
Related Topics
Concepts
Medicine
Thrombolysis
Stroke (engine)
Pandemic
Coronavirus disease 2019 (COVID-19)
Emergency medicine
Interrupted Time Series Analysis
Ischemic stroke
Internal medicine
Outpatient clinic
Incidence (geometry)
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Pediatrics
Ischemia
Myocardial infarction
Mechanical engineering
Mathematics
Disease
Engineering
Statistics
Physics
Optics
Infectious disease (medical specialty)
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3389/fneur.2024.1351769
- https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1351769/pdf
- OA Status
- gold
- Cited By
- 2
- References
- 35
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4391611885
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4391611885Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.3389/fneur.2024.1351769Digital Object Identifier
- Title
-
Rapid outpatient transient ischemic attack clinic and stroke service activity during the SARS-CoV-2 pandemic: a multicenter time series analysisWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-02-07Full publication date if available
- Authors
-
Andy Lim, Peter M. Rothwell, Linxin Li, Shelagh B. Coutts, Michael D. Hill, Maria Guarino, Valentina Barone, Francesca Rondelli, Timothy Kleinig, Reid Cornell-Farrow, Martín Krause, Miriam Wronski, Shaloo Singhal, Henry Ma, Thanh G. PhanList of authors in order
- Landing page
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https://doi.org/10.3389/fneur.2024.1351769Publisher landing page
- PDF URL
-
https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1351769/pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1351769/pdfDirect OA link when available
- Concepts
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Medicine, Thrombolysis, Stroke (engine), Pandemic, Coronavirus disease 2019 (COVID-19), Emergency medicine, Interrupted Time Series Analysis, Ischemic stroke, Internal medicine, Outpatient clinic, Incidence (geometry), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pediatrics, Ischemia, Myocardial infarction, Mechanical engineering, Mathematics, Disease, Engineering, Statistics, Physics, Optics, Infectious disease (medical specialty)Top concepts (fields/topics) attached by OpenAlex
- Cited by
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2Total citation count in OpenAlex
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2025: 1, 2024: 1Per-year citation counts (last 5 years)
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35Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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