King's College London
School of Population Health and Environmental Sciences

Presenter Of 2 Presentations

HOW HAS THE COVID-19 PANDEMIC AFFECTED THROMBOLYSIS RATES IN ACUTE HOSPITALS ACROSS THE UK? DATA FROM THE NATIONAL STROKE REGISTRY

Session Type
Free Communication Session
Date
28.10.2021, Thursday
Session Time
08:00 - 09:30
Room
FREE COMMUNICATIONS A
Lecture Time
08:10 - 08:20

Abstract

Background and Aims

Intravenous thrombolysis (IVT) can reduce disability after acute ischaemic stroke. The IVT rate in the UK (as a percentage of all strokes) has remained stable at 11-12% over the past 7 years.

Methods

Data from January 2019-December 2020 were extracted from the Sentinel Stroke National Audit Programme (SSNAP), a national registry covering 92% of the UK population. For all stroke admissions, we compared the annual and monthly IVT rates at national and regional level. Chi-squared was used to test the differences between cohorts.

Results

thrombolysis rates 2019-2020.png174,321 stroke patients were admitted to acute hospitals over two years. The national IVT rate decreased from 11.6% in 2019 to 11% in 2020, p<0.001. During the first UK COVID peak in March/April 2020, the IVT rate remained stable (11.6% in 2019 compared to 11.8% in 2020, p=0.652). However, IVT rates began to fall after April 2020, with a pronounced decline from autumn onwards (10.2% in September-December 2020 compared to 11.6% in September-December 2019, p<0.001).

Conclusions

Data shows that whilst the IVT rate was maintained during the early months of the pandemic (March-April 2020), rates began to decline through mid to late 2020. Further investigation is required to determine the underlying cause(s), which may include admission rates, organisational changes and increases in pre-hospital and in-hospital pathway timings, as well as to explore regional differences, as the pandemic affected different UK regions at different intensities.

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HOW HAS THE COVID-19 PANDEMIC AFFECTED THROMBECTOMY RATES IN ACUTE HOSPITALS ACROSS THE UK? DATA FROM THE NATIONAL STROKE REGISTRY

Session Type
Free Communication Session
Date
28.10.2021, Thursday
Session Time
08:00 - 09:30
Room
FREE COMMUNICATIONS A
Lecture Time
08:20 - 08:30

Abstract

Background and Aims

Mechanical thrombectomy (MT) in acute ischaemic stroke can reduce the severity of post-stroke disability. The MT rate in the UK (as a percentage of all strokes) has been steadily increasing from 0.7% in 2016/17 to 1.8% in 2019/20.

Methods

Data from January 2019 to December 2020 were extracted from the Sentinel Stroke National Audit Programme (SSNAP), a national registry covering 92% of the UK population. For all stroke admissions, we compared the annual and monthly MT rates at a national and regional level. Chi-squared was used to test the differences between cohorts.

Results

174,321 stroke patients were admitted to acute hospitals over two years. The proportion of patients receiving MT increased from 1.69% in 2019 to 1.94% in 2020, p<0.001. No reduction in MT rates was observed during the COVID period, however the previous gradual increase has slowed.

thrombectomy graph.png

Conclusions

Whilst the national MT rate has remained consistent with pre-COVID levels demonstrating that access to the treatment has been maintained throughout the pandemic, the rate has fallen short of the expected year-on-year growth and arrested the trajectory towards the NHS ambition of a 10% MT rate by 2022.

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