Presenter of 5 Presentations
IMPACT OF COVID-19 PANDEMIC ON STROKE TREATMENT: A MULTICENTER STUDY IN MEXICO
LONG-TERM SOCIAL IMPACT IN PATIENTS WITH CEREBRAL VENOUS THROMBOSIS
IMPACT OF COVID-19 PANDEMIC ON STROKE TREATMENT: A MULTICENTER STUDY IN MEXICO
Abstract
Background and Aims
The COVID-19 pandemic led to changes in patient care in health systems in Mexico, including treatment o stroke. Therefore, the aim of our study was to estimate the impact of COVID-19 pandemic on stroke treatment in Mexico.
Methods
We performed an observational, retrospective, multicenter study that included patients with stroke from May 2020 to January 2022. COVID-19 positive status was defined by positive PCR or chest tomography with CO-RADS 4-5. The treatment received was divided according to the type of stroke and the patient´s status in relation to SARS-CoV-2 infection.
Results
1272 patients with stroke were included, 110(8.6 %) had COVID-19 diagnosis, 667(52.4%) were men, the mean age was lower in COVID-19 patients (61.48 +15 years versus 64.97+15 years [16-99]; p=0.022). Comparisons between treatment and the different subtypes of stroke with and without COVID-19 were as follows: in acute ischemic stroke (AIS), reperfusión therapy was more frequent in patients without COVID-19 (149 [16.6 %] versus 6 [7.4 %]; p<0.001), in spontaneous intracerebral hemorrhage, management with only medical treatment in patients with and without COVID-19 was similar (18[100 %] versus 161[87.5 %]; p=0.233), finally, treatment in all patients with transient ischemic attack and cerebral venous thrombosis was only with medical treatment.
Conclusions
In our study, patients with COVID-19 and AIS received less management with reperfusion therapy, without significant changes in treatment in the other subtypes of strokes. With the above demonstrating the negative impact of the COVID-19 pandemic on treatment of AIS in Mexico.
LONG-TERM SOCIAL IMPACT IN PATIENTS WITH CEREBRAL VENOUS THROMBOSIS
Abstract
Background and Aims
Cerebral venous thrombosis(CVT) mostly affects young people. In general, the functional outcome in the vast majority is good, however, other aspects like psychosocial are important to establish the burden of disease. Therefore the purpose of this study is to quantify the impact of CVT in certain aspects such as negative change in laboral condition, income reduction and the divorce rate as some of the other long-term impact markers in patients with CVT.
Methods
We conducted a cohort study of patients with CVT at the Instituto Nacional de Neurología y Neurocirugía in Mexico city from 2015 to 2020 with at least 24 months follow-up. The divorce frequency, negative change in laboral condition and an income reduction was determinated; and its association with patient characteristics, demographics, clinical aspects and comorbidities were calculated trough Fisher´s-exact-test considering significant values p <0.05.
Results
51 cases of CVT were identified. The mean age was 41.9 +/- 13.5 years, 18 (35.3%) were male. After CVT,18.7% patients got a divorce and 31(62%) changed their laboral condition in a negative form and experienced an income reduction. The divorce frequency was higher among women (21.2% vs 0%,p=0.042),while perception of less income was more frequent in men (82% vs. 51%, p=0.032).The other variables evaluated were not statistically significant (p>0.05).
Conclusions
Long-term impact of CVT goes beyond the clinical outcomes. The burden in social, economic and personal aspects was frequent in our study with gender-specific association.These results should be interpreted with caution, as they probably reflect some aspects of the idiosyncrasy of our population.
PERSISTENT HEADACHE AS A LONG-TERM RESIDUAL CONDITION IN PATIENTS WITH CEREBRAL VENOUS THROMBOSIS
Abstract
Background and Aims
Acute headache is the most frequent manifestation (90%) in patients with cerebral venous thrombosis (CVT) and the unique manifestation in 15%, but there is limited information related to long persistence headache in CVT. The aim of this study is to stablish the persistent headache frequency, its burden in patients and its relationship with other previously known severity variables in CVT.
Methods
We evaluated the cohort-study of patients with CVT at the Instituto Nacional de Neurologia y Neurocirugia in Mexico city between 2015 and 2021, in patients with at least 6 months of follow-up. The frequency of persistent headache defined as headache that persists beyond 3 months after CVT and its association with risk features of CVT (presence of hematoma, compromised venous sinuses, onset), clinical data (acute headache,altered consciousness,weakness) and comorbidities (pregnancy,infection,thrombophilia) were determinated through chi square-test, considering significant values p <0.05.
Results
86 patients were included, the mean age was 40 years +/- 14, 26 (30.2%) were male. In 54(62.8%) persistant headache was identified, all patients used painkillers. In the bivariate analysis, no association was identified with the characteristics of thrombosis, clinical or demographic data (p>0.05).
Conclusions
In our study persistent headache in patients with CVT was a very frequent residual condition with an extensive painkiller use. These results should be interpreted with caution due to the small sample of patients included.