An Example of a Stroke Unit Reshaping in the Context of a Regional Hub and Spoke System in the COVID-19 Era
Rattachement africain : it. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
During the COVID-19 outbreak, the Neurology and Stroke Unit (SU) of the hospital of Varese had to serve as a cerebrovascular hub, meaning that the referral area for the unit doubled. The number of beds in the SU was increased from 4 to 8. We took advantage of the temporary suspension of the out-patient clinic and reshaped our activity to guarantee the 24/7 availability of recombinant tissue Plasminogen Activator (rtPA) intravenous therapy (IVT) in the SU, and to ensure we were able to admit patients to the SU as soon as they completed endovascular treatment (EVT). In 42 days, 46 stroke patients were admitted to our hospital, and 34.7% of them underwent IVT and/or EVT, which means that we treated 0.38 patients per day; in the baseline period from 2016 to 2018, these same figures had been 23.5% and 0.23, respectively. The mean values of the door-to-first CT/MRI and the door-to-groin puncture, but not of the onset-to-door and the door-to-needle periods were slightly but significantly longer than those observed in the baseline period in 276 patients. On an individual basis, only one patient exceeded the door-to-groin puncture time limit computed from the baseline period by about 10 min. None of the patients had a major complication following the procedures. None of the patients was or became SARS-CoV2 positive. In conclusion, we were able to manage the new hub-and-spoke system safely and without significant delays. The reshaping of the SU was made possible by the significant reduction of out-patient activity. The consequences of this reduction are still unknown but eventually, this emergency will suggest ways to reconsider the management and the allocation of health system resources.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- An Example of a Stroke Unit Reshaping in the Context of a Regional Hub and Spoke System in the COVID-19 Era
- Date Crossref
- 15/10/2020
- Éditeur
- Frontiers Media SA
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Fondazione Audiologica Varese pays non établi dans la noticeOrganisation à but non lucratif
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University of Milano-Bicocca pays non établi dans la noticeUniversité ou école supérieure
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University of Insubria pays non établi dans la noticeUniversité ou école supérieure
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Neurology and Stroke Units pays non établi dans la noticeInstitution
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Bicocca University Department of Medicine and Surgery pays non établi dans la noticeUniversité ou école supérieure
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Insubria University Department of Medicine and Surgery pays non établi dans la noticeUniversité ou école supérieure
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Neuroradiology Unit pays non établi dans la noticeInstitution
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Vascular Surgery Unit pays non établi dans la noticeInstitution
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Emergency Department pays non établi dans la noticeInstitution
Fondazione Audiologica Varese, University of Milano-Bicocca et University of Insubria, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.