IMPACT OF IN-HOSPITAL COVID-19 QUARANTINE POLICY ON THE QUALITY OF CARE OF HYPERACUTE STROKE: A SINGLE-CENTER STUDY

초록

Background and Aims: The COVID-19 pandemic may impact in-hospital processes for hyperacute stroke patients, potentially resulting in delays due to quarantine and screening measures. Our study focused on how quarantine policies affect managing acute stroke patients. Methods: We conducted a comprehensive analysis of 268 hyperacute ischemic stroke patients who visited Korea University Guro Hospital's emergency department (ED) from January 2019 to February 2021. All patients encompassed the neurological symptoms within 6 hours prior to arrival and a direct referral to a neurologist. Quality indicators, including door-to-image time (DIT), door-toreferral time, door-to-needle time (DNT), and door-to-puncture time (DPT), with clinical outcomes, were assessed. The implementation of mandatory COVID-19 PCR testing for all ED patients, initiated in March 2020, prompted a comparative analysis between pre-COVID and post-COVID periods. Results: A cohort of 268 hyperacute stroke patients was enrolled in the study, revealing a gradual decline in the number of such patients over the period. Time indicators, including door-to-referral time (DRT), door-to-image time (DIT), and door-to-puncture time (DPT), showed an increase. Upon comparative analysis between pre- and post-COVID screening epochs, a statistically significant delay in DIT emerged during the post-COVID screening epoch (median 11 minutes [Interquartile range: 7-18 minutes] compared to 14 [10-24], p<0.001). Although delays were observed in DRT (20 [13-29] compared to 23 [16-35], p¼0.08) and DPT (137 [120-170] to 158 [133-192], p¼0.09), these differences didn't reach statistical significance. Importantly, despite these temporal variations, there were no discernible differences in clinical outcomes Conclusions: Our study reveals delays in acute stroke management, likely attributed to in-hospital COVID-19 quarantine, highlighting the impact of such measures on patient care. To enhance preparedness, and protocols for such emergency response during a pandemic, and ensure adequate training and drills for healthcare professionals in the hospital. Also, education and evaluations of pandemic response plans may help identify and address potential weaknesses in Abstracts Atherosclerosis 395 (2024) 117627 145 the system.