COVID-19 Pandemic and Quality of Care and Outcomes of Acute Stroke Hospitalizations: the Paul Coverdell National Acute Stroke Program

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Tong, Xin ; King, Sallyann M. Coleman ; Asaithambi, Ganesh ; Odom, Erika ; Yang, Quanhe ; Yin, Xiaoping ; Merritt, Robert K.
• Description:
  Introduction
  
  Studies documented significant reductions in emergency department visits and hospitalizations for acute stroke during the COVID-19 pandemic. A limited number of studies assessed the adherence to stroke performance measures during the pandemic. We examined rates of stroke hospitalization and adherence to stroke quality-of-care measures before and during the early phase of pandemic.
  
  Methods
  
  We identified hospitalizations with a clinical diagnosis of acute stroke or transient ischemic attack among 406 hospitals who contributed data to the Paul Coverdell National Acute Stroke Program. We used 10 performance measures to examine the effect of the pandemic on stroke quality of care. We compared data from 2 periods: pre–COVID-19 (week 11–24 in 2019) and COVID-19 (week 11–24 in 2020). We used χ2 tests for differences in categorical variables and the Wilcoxon–Mann–Whitney rank test or Kruskal–Wallis test for continuous variables.
  
  Results
  
  We identified 64,461 hospitalizations. We observed a 20.2% reduction in stroke hospitalizations (from 35,851 to 28,610) from the pre–COVID-19 period to the COVID-19 period. Hospitalizations among patients aged 85 or older, women, and non-Hispanic White patients declined the most. A greater percentage of patients aged 18 to 64 were hospitalized with ischemic stroke during COVID-19 than during pre–COVID-19 (34.4% vs 32.5%, P < .001). Stroke severity was higher during COVID-19 than during pre–COVID-19 for both hemorrhagic stroke and ischemic stroke, and in-hospital death among patients with ischemic stroke increased from 4.3% to 5.0% (P = .003) during the study period. We found no differences in rates of receiving care across stroke type during the study period.
  
  Conclusion
  
  Despite a significant reduction in stroke hospitalizations, more severe stroke among hospitalized patients, and an increase in in-hospital death during the pandemic period, we found no differences in adherence to quality of stroke care measures.
  
  
• Subjects:
  Adolescent Adult Aged Aged, 80 And Over COVID-19 Female Hospitalization Hospital Mortality Humans Male Medicare Middle Aged Pandemics Quality Of Health Care Retrospective Studies Stroke Young Adult

  More +
• Source:
  Prev Chronic Dis. 2021; 18
• DOI:
  http://dx.doi.org/10.5888/pcd18.210130
• ISSN:
  1545-1151
• Pubmed ID:
  34410906
• Pubmed Central ID:
  PMC8388201
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Location:
  North America
• Volume:
  18
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:d04e808032d05aef28e67dfb0632e4c7eef4e93d887285f560d366165130b94f96ed24de1e5bc9f10d574585296f107b24d7337ebb2c709e05c2b70eb071dd51
• Download URL:
  https://stacks.cdc.gov/view/cdc/109782/cdc_109782_DS1.pdf
• File Type:
  [PDF - 513.49 KB ]