Abstract Details

Title Impact of COVID-19 on Stroke in Minnesota

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P8 - Poster Session 8 (5:30 PM-6:30 PM)

Poster/Presentation
Number 5-009

Objective To determine the impact of COVID-19 pandemic on stroke presentations in a statewide database.

Background

The COVID-19 pandemic has had a profound impact on healthcare worldwide, with numerous stroke patients avoiding medical care during this time, resulting in adverse outcomes.

Design/Methods We conducted a retrospective analysis of the Minnesota Hospital Association database which contains individual-level data. Using ICD-10 codes, adult patients admitted in 2019 (pre-pandemic group) and 2020 (pandemic group) with any stroke diagnosis were identified. Monthly volume trends were analyzed across the two. The two groups were compared in terms of demographics, geography, stroke types, therapies, and outcomes. The Standardized Mean Difference (SMD) is reported for each variable as a method to compare the two groups with values ≥0.1 indicating a noteworthy imbalance between groups.

Results Total stroke volume dropped from 17,249 in 2019 to 16,236 in 2020 (??2=45.1, p<0.001). Non-Hispanic White patients experienced the most pronounced drop (SMD 0.125). A larger proportion of stroke cases were in urban compared to rural regions in 2020 (73.9%) compared to 2019 (68.7%). There was a sharp decline in volume in March-April 2020, aligning with stay-at-home orders, with subsequent increase in stroke volume despite the rise in COVID volume. Fewer ischemic stroke patients received reperfusion therapies, however, the utilization rates of IV thrombolysis (SMD 0.021) and mechanical thrombectomy (0.036) were similar. Length of stay and total charges were higher in 2020 especially for ischemic stroke patients who received reperfusion therapies. Mortality and non-home discharge rates were similar.

Conclusions The decline in stroke cases was primarily associated with the stay-at-home orders rather than the actual COVID case volume. It is important to message the public in a manner that does not deter from seeking immediate care for non-COVID medical emergencies.

Authors/Disclosures
Haitham Hussein, MD, FAAN (University of Minnesota Medical School) PRESENTER	Dr. Hussein has nothing to disclose.
David Schneck	No disclosure on file
Nitin Ramanujam Chakravarthula, MBBS (University of Minnesota)	Dr. Chakravarthula has nothing to disclose.
Annette Xenopoulos-Oddsson (University of Minnesota, Masonic Institute for the Developing Brain)	Annette Xenopoulos-Oddsson has nothing to disclose.
Mark Fiecas	No disclosure on file

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