Table 1.
Demographics and key performance measures
| Pre-COVID-19 (n=428) | COVID-19 (n=441) | P value | |
|---|---|---|---|
| ED adult presentations | 38,576 | 35,172 | |
| Number of stroke code activations, n (%) | 742 (1.9) | 712 (2.0) | 0.33 |
| Diagnosis of stroke / TIA, n (%) | 428 (57.7) | 441 (61.9) | 0.10 |
| Age, median (IQR) | 77 (66-86) | 77 (67-85) | 0.89 |
| Gender, female n (%) | 209 (48.8) | 225 (51.0) | 0.54 |
| Type of stroke diagnosis at discharge, n (%) | |||
| Ischaemic1 | 295 (68.9) | 290 (65.8) | 0.32 |
| Intracranial haemorrhage (ICH) | 66 (15.4) | 95 (21.5) | 0.02 |
| TIA | 67 (15.7) | 56 (12.7) | 0.21 |
| Known symptom onset, n (%) | 235 (54.9) | 243 (55.1) | 1.00 |
| Time from known onset to ED presentation, minutes median (IQR) | 134 (71-251) | 134 (77-238) | 0.53 |
| ASU or NSICU or NSDU admission2, n (%) | 365 (85.3) | 378 (85.7) | 0.86 |
| Time from ED presentation to ASU or NSICU or NSDU3, minutes median (IQR) | 295 (188-555) | 260 (183-448) | 0.03 |
| Time from presentation to first CT brain imaging4, minutes median (IQR) | 32 (19-85) | 30 (20-63) | 0.57 |
| Reperfusion therapy, ischemic strokes | |||
| IV thrombolysis, n (%) | 51 (17.3) | 52 (17.9) | 0.84 |
| ECR, n (%) | 38 (12.9) | 46 (15.9) | 0.30 |
| Time from presentation to IVtPA infusion, minutes median (IQR) | 60 (43-90) | 65 (45-96) | 0.53 |
| Time of onset of stroke to IVtPA infusion, minutes median (IQR) | 166 (117–218) | 186 (136–239) | 0.18 |
1 1Patients with ICD code I64 (Stroke, not specified) are included in Ischaemic strokes as they were clinically diagnosed as ischaemic strokes (9 vs 3).
2 2Includes patients who were admitted to ASU or NSICU or NSDU as first ward after presentation to the ED.
3 3Includes patients who were admitted to ASU or NSICU or NSDU after presentation to the ED; excludes direct admissions (no ED) (29 vs 20), patients admitted to other types of wards (24 vs 32), patients only admitted to the ED short stay unit (6 vs 7), and patients who transferred from the ED to other hospitals for clot retrieval and then were repatriated back to the hospital (6 vs 6).
4 4Excluded: CT brain performed at referring hospitals: 69 vs 85
ASU = acute stroke unit, CT = computed tomography, ED = emergency department, ECR = endovascular clot retrieval, ICH = intracranial heamorrhage, IQR = interquartile range, NSICU =neuroscience intensive care unit, NSDU = neurosurgical surgical dependency unit, IVtPA = intravenous tissue plasminogen activator, TIA = transient ischaemic attack
Table 2.
Length of stay, stroke severity and outcomes
| Pre-COVID-19 (n=428) | COVID-19 (n=441) | P value | |
|---|---|---|---|
| Episode LOS, days, median (IQR) | 4.0 (2-7) | 4.7 (3-8) | 0.06 |
| Hospital LOS, days, median (IQR) | 6.0 (3-10) | 6.0 (3.5-10) | 0.61 |
| Pre mRS1, median (IQR) | 0 (0-2) | 0 (0-2) | 0.92 |
| NIHSS baseline2, median (IQR) | 3 (1-9) | 4 (1-11) | 0.049 |
| Discharge mRS3, median (IQR) | 3 (0-4) | 3 (0-4) | 0.18 |
| Severe events, n (%) | 54 (12.6) | 55 (12.5) | 0.95 |
| In-hospital Mortality, n (%) | 40 (9.3) | 55 (12.5) | 0.16 |
| Readmission within 28 days, n (%) | 32 (7.5) | 22 (5.0) | 0.16 |
| 3 months mRS4, median (IQR) | 2 (1-3) | 2 (1-3) | 0.92 |