Fewer people with stroke symptoms receiving care at US hospitals during pandemic.
A new study led by Indian American researchers gives a troubling indication that many people in America who experience strokes during the coronavirus pandemic may not be seeking potentially life-saving medical care.
The study led by researchers from Washington University School of Medicine in St. Louis has found that stroke evaluations at US hospitals fell by nearly 40% during a pandemic period suggesting this conclusion.
The findings of the study analyzing stroke evaluations at more than 800 hospitals across 49 states and Washington, DC, were published in the New England Journal of Medicine, last week.
“Our stroke team has maintained full capacity to provide emergency stroke treatment at all times, even during the height of the pandemic,” said lead author Akash Kansagra, MD, an assistant professor of radiology at Washington University’s Mallinckrodt Institute of Radiology (MIR) in a news release.
“Nevertheless, we have seen a smaller number of stroke patients coming to the hospital and some patients arriving at the hospital after a considerable delay,” said Kansagra, who sees stroke patients at Barnes-Jewish Hospital.
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“It is absolutely heartbreaking to meet a patient who might have recovered from a stroke but, for whatever reason, waited too long to seek treatment.”
Nearly 800,000 people in the US experience a stroke every year. It is the fifth leading cause of death and the leading cause of long-term disability.
Worried by the low numbers of stroke patients being evaluated at Barnes-Jewish Hospital and hearing similar reports from colleagues at other institutions, Kansagra’s team set out to determine how pervasive the problem was, the release said.
Co-authors of the study are Manu Goyal, MD, a Washington University assistant professor of radiology and neurology, and statistician Scott Hamilton, PhD, and neurologist Gregory Albers, MD, both of Stanford University.
Kansagra and colleagues assessed how often a brain scan software known as RAPID was used in February, before the pandemic, and during a two-week period from March 26 to April 8, when much of the US was under shelter-in-place orders.
In total, the software was used for 231,753 patients at 856 hospitals representing Washington, DC, and all 50 states except New Hampshire.
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During February, the software was used for an average of 1.18 patients per day per hospital. During the pandemic period, software use per hospital averaged 0.72 patients per day, a drop of 39%.
“Across the board, everybody is affected by this decrease,” said Kansagra, who is also an assistant professor of neurosurgery and of neurology.
“It is not limited to just hospitals in urban settings or rural communities, small hospitals or large hospitals,” he said. “Even patients with really severe strokes are seeking care at reduced rates. This is a widespread and very scary phenomenon.”
“I suspect we are witnessing a combination of patients being reluctant to seek care out of fear that they might contract covid-19, and the effects of social distancing,” Kansagra said.
“In an era when we are all isolating at home, it may be that patients who have strokes aren’t discovered quickly enough,” he said. But even during a pandemic, it is critically important for people who may be experiencing a stroke to receive care immediately, Kansagra said.
The risk of delaying care for a stroke is much greater than the risk of contracting covid-19. “The effect of coming in too late is the same in many respects as not coming in at all,” Kansagra said.