Monash University
Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health
Professor Dominique Cadilhac (PhD, MPH, BN, RN) is a health services researcher and NHMRC Senior Research Fellow with over 260 articles. She heads the Public Health group within the Stroke theme at the Florey and is the Data Custodian for the Australian Stroke Clinical Registry. She is also the Head of the Translational Public Health and Evaluation Research Division, Stroke and Ageing Research at Monash University. Her skillset includes epidemiology, implementation science and economic evaluation.

Presenter Of 1 Presentation

THE DETRIMENTAL IMPACT OF NOT MAINTAINING ACCESS TO STROKE UNITS DURING THE COVID-19 PANDEMIC

Session Type
Free Communication Session
Date
28.10.2021, Thursday
Session Time
15:45 - 17:15
Room
FREE COMMUNICATIONS A
Lecture Time
16:05 - 16:15

Abstract

Background and Aims

Changes to hospital resourcing related to acute stroke care have occurred as a by-product of the COVID-19 pandemic. There is uncertainty on the impacts this has had on the quality of care. We aimed to compare the provision of acute stroke care provided in stroke units with alternate ward settings during the pandemic.

Methods

Patients admitted with stroke or transient ischaemic attack from 61 hospitals contributing data to the Australian Stroke Clinical Registry in 2019 and 2020 were included. Interrupted time series analysis was conducted to assess trends in the provision of therapies before and after two critical pandemic time points in Australia: the first wave (starting 1/3/2020); and the second wave (between 9/7/2020-20/10/2020).

Results

There were 19,164 admissions in 2019 and 19,131 admissions in 2020 included, with no differences in age and sex between years (mean age 73 years, 56% male). Fewer patients were provided treatment in a stroke unit in 2020 compared to 2019 (72% vs 77%, p<0.001). There were greater declines in the provision of hyperacute aspirin and secondary prevention medications at discharge in alternate wards than stroke units during the second wave (between 0.41% and 1.31% per week). Provision of mobilisation and swallow screening/assessment declined in alternate wards only. Provision of care planning at discharge improved in alternate wards relative to stroke units by 0.49% per week during the first wave and 1.14% per week during the second wave.

Conclusions

Maintaining access to stroke units is paramount to ensuring best practice care even during a pandemic.

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