Data_Sheet_1_COVID-19 Pandemic Impact on Care for Stroke in Australia: Emerging Evidence From the Australian Stroke Clinical Registry.PDF

We present information on acute stroke care for the first wave of the COVID-19 pandemic in Australia using data from the Australian Stroke Clinical Registry (AuSCR). The first case of COVID-19 in Australia was recorded in late January 2020 and national restrictions to control the virus commenced in March. To account for seasonal effects of stroke admissions, patient-level data from the registry from January to June 2020 were compared to the same period in 2019 (historical-control) from 61 public hospitals. We compared periods using descriptive statistics and performed interrupted time series analyses. Perceptions of stroke clinicians were obtained from 53/72 (74%) hospitals participating in the AuSCR (80% nurses) via a voluntary, electronic feedback survey. Survey data were summarized to provide contextual information for the registry-based analysis. Data from the registry covered locations that had 91% of Australian COVID-19 cases to the end of June 2020. For the historical-control period, 9,308 episodes of care were compared with the pandemic period (8,992 episodes). Patient characteristics were similar for each cohort (median age: 75 years; 56% male; ischemic stroke 69%). Treatment in stroke units decreased progressively during the pandemic period (control: 76% pandemic: 70%, p < 0.001). Clinical staff reported fewer resources available for stroke including 10% reporting reduced stroke unit beds. Several time-based metrics were unchanged whereas door-to-needle times were longer during the peak pandemic period (March-April, 2020; 82 min, control: 74 min, p = 0.012). Our data emphasize the need to maintain appropriate acute stroke care during times of national emergency such as pandemic management.

本研究旨在利用澳大利亚卒中临床登记系统（AuSCR）的数据，对COVID-19疫情初期澳大利亚急性卒中护理情况进行探讨。澳大利亚首例COVID-19病例于2020年1月下旬被记录，而全国性限制措施于3月开始实施。为了消除卒中入院的季节性影响，我们将2020年1月至6月的患者级别数据与2019年同期（历史对照）的61家公立医院进行了比较。我们采用描述性统计和中断时间序列分析方法对两个时期进行了比较。通过自愿的电子反馈调查，从参与AuSCR的53/72（74%）的医院（80%为护士）收集了卒中临床医生的看法。调查数据被总结，为基于登记系统的分析提供背景信息。登记数据涵盖了截至2020年6月底91%的澳大利亚COVID-19病例的地区。对于历史对照时期，9,308例护理病例与疫情时期（8,992例）进行了比较。每个队列的患者特征相似（中位年龄：75岁；56%为男性；69%为缺血性卒中）。在疫情期间，卒中单元的治疗方法逐渐减少（对照：76%，疫情：70%，p < 0.001）。临床工作人员报告称，用于卒中的资源减少，其中10%的人报告卒中单元床位减少。尽管一些基于时间的指标没有变化，但门到针时间在疫情高峰期（2020年3月至4月；82分钟，对照：74分钟，p = 0.012）有所延长。我们的数据强调了在诸如疫情管理等国家紧急情况下维持适当急性卒中护理的必要性。