Social and clinical vulnerability in stroke and STEMI management during the COVID-19 pandemic: a registry-based study

Publié le 3 janvier 2024
Mis à jour le 14 février 2024

OBJECTIVE: This study aims to evaluate whether the first wave of the COVID-19 pandemic resulted in a deterioration in the quality of care for socially and/or clinically vulnerable stroke and ST-segment elevation myocardial infarction (STEMI) patients. DESIGN: Two cohorts of STEMI and stroke patients in the Aquitaine neurocardiovascular registry. SETTING: Six emergency medical services, 30 emergency units, 14 hospitalisation units and 11 catheterisation laboratories in the Aquitaine region in France. PARTICIPANTS: This study involved 9218 patients (6436 stroke and 2782 STEMI patients) in the neurocardiovascular registry from January 2019 to August 2020. PRIMARY OUTCOME MEASURES: Care management times in both cohorts: first medical contact-to-procedure time for the STEMI cohort and emergency unit admission-to-imaging time for the stroke cohort. Associations between social (deprivation index) and clinical (age >65 years, neurocardiovascular history) vulnerabilities and care management times were analysed using multivariate linear mixed models, with an interaction on the time period (pre-wave, per-wave and post-first COVID-19 wave). RESULTS: The first medical contact procedure time was longer for elderly (p

Auteur : Lesaine Emilie, Francis Florence, Domecq Sandrine, Miganeh-Hadi Sahal, Sevin Floriane, Sibon Igor, Rouanet François, Pradeau Catherine, Coste Pierre, Cetran Laura, Vandentorren Stephanie, Saillour Florence
BMJ open, 2024, vol. 14, n°. 1, p. e073933