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International Experience of Mechanical Thrombectomy During the COVID-19 Pandemic: Insights from STAR and ENRG

2020Journal article Open access
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dc.contributor.authorKasab, S
dc.contributor.authorAlmallouhi, E
dc.contributor.authorAlawieh, A
dc.contributor.authorLevitt, M
dc.contributor.authorJabbour, P
dc.contributor.authorSweid, A
dc.contributor.authorStarke, R
dc.contributor.authorSaini, V
dc.contributor.authorWolfe, S
dc.contributor.authorFargen, K
dc.contributor.authorArthur, A
dc.contributor.authorGoyal, N
dc.contributor.authorPandhi, A
dc.contributor.authorFragata, I
dc.contributor.authorMaier, I
dc.contributor.authorMatouk, C
dc.contributor.authorGrossberg, J
dc.contributor.authorHoward, B
dc.contributor.authorKan, P
dc.contributor.authorHafeez, M
dc.contributor.authorSchirmer, C
dc.contributor.authorCrowley, R
dc.contributor.authorJoshi, K
dc.contributor.authorTjoumakaris, S
dc.contributor.authorChowdry, S
dc.contributor.authorAres, W
dc.contributor.authorOgilvy, C
dc.contributor.authorGomez-Paz, S
dc.contributor.authorRai, A
dc.contributor.authorMokin, M
dc.contributor.authorGuerrero, W
dc.contributor.authorPark, M
dc.contributor.authorMascitelli, J
dc.contributor.authorYoo, A
dc.contributor.authorWilliamson, R
dc.contributor.authorGrande, A
dc.contributor.authorCrosa, R
dc.contributor.authorWebb, S
dc.contributor.authorPsychogios, M
dc.contributor.authorDucruet, A
dc.contributor.authorHolmstedt, C
dc.contributor.authorRinger, A
dc.contributor.authorSpiotta, A
dc.date.accessioned2022-04-29T12:03:39Z
dc.date.available2022-04-29T12:03:39Z
dc.date.issued2020
dc.description.abstractBackground: In response to the COVID-19 pandemic, many centers altered stroke triage protocols for the protection of their providers. However, the effect of workflow changes on stroke patients receiving mechanical thrombectomy (MT) has not been systematically studied. Methods: A prospective international study was launched at the initiation of the COVID-19 pandemic. All included centers participated in the Stroke Thrombectomy and Aneurysm Registry (STAR) and Endovascular Neurosurgery Research Group (ENRG). Data was collected during the peak months of the COVID-19 surge at each site. Collected data included patient and disease characteristics. A generalized linear model with logit link function was used to estimate the effect of general anesthesia (GA) on in-hospital mortality and discharge outcome controlling for confounders. Results: 458 patients and 28 centers were included from North America, South America, and Europe. Five centers were in high-COVID burden counties (HCC) in which 9/104 (8.7%) of patients were positive for COVID-19 compared with 4/354 (1.1%) in low-COVID burden counties (LCC) (P<0.001). 241 patients underwent pre-procedure GA. Compared with patients treated awake, GA patients had longer door to reperfusion time (138 vs 100 min, P=<0.001). On multivariate analysis, GA was associated with higher probability of in-hospital mortality (RR 1.871, P=0.029) and lower probability of functional independence at discharge (RR 0.53, P=0.015). Conclusion: We observed a low rate of COVID-19 infection among stroke patients undergoing MT in LCC. Overall, more than half of the patients underwent intubation prior to MT, leading to prolonged door to reperfusion time, higher in-hospital mortality, and lower likelihood of functional independence at discharge.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Neurointerv Surg. 2020 Nov;12(11):1039-1044.pt_PT
dc.identifier.doi10.1136/neurintsurg-2020-016671.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4054
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBMJpt_PT
dc.subjectHSJ NRADpt_PT
dc.subjectAgedpt_PT
dc.subjectAged, 80 and overpt_PT
dc.subjectMiddle Agedpt_PT
dc.subjectHumanspt_PT
dc.subjectFemalept_PT
dc.subjectMalept_PT
dc.subjectAnesthesia, Generalpt_PT
dc.subjectCOVID-19pt_PT
dc.subjectCoronavirus Infections*pt_PT
dc.subjectEndovascular Procedurespt_PT
dc.subjectHospital Mortalitypt_PT
dc.subjectIndependent Livingpt_PT
dc.subjectLinear Modelspt_PT
dc.subjectPandemics*pt_PT
dc.subjectPneumonia, Viral*pt_PT
dc.subjectProspective Studiespt_PT
dc.subjectReperfusionpt_PT
dc.subjectStroke / therapy*pt_PT
dc.subjectThrombectomy / methodspt_PT
dc.subjectThrombectomy / statistics & numerical data*pt_PT
dc.subjectTreatment Outcomept_PT
dc.subjectWorkflowpt_PT
dc.titleInternational Experience of Mechanical Thrombectomy During the COVID-19 Pandemic: Insights from STAR and ENRGpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1044pt_PT
oaire.citation.startPage1039pt_PT
oaire.citation.titleJournal of Neurointerventional Surgerypt_PT
oaire.citation.volume12pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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