Author:
Venkatachalam Aardhra M.,Hossain Sayeeda R.,Manchi Maunica R.,Chavez Audrie A.,Abraham Annie M.,Stone Suzanne,Truong Vincent,Cobos Carrie U.,Khuong Toan,Atem Folefac D.,Welch Babu G.,Ifejika Nneka L.
Abstract
Objective
The aim of the study is to evaluate transitions of acute stroke and inpatient rehabilitation facility care during the first wave of COVID-19.
Design
This is a retrospective observational study (3 comprehensive stroke centers with hospital-based inpatient rehabilitation facilities) between January 1, 2019, and May 31, 2019 (acute stroke = 584, inpatient rehabilitation facility = 210) and January 1, 2020, and May 31, 2020 (acute stroke = 534, inpatient rehabilitation facility = 186). Acute stroke characteristics included stroke type, demographics, and medical comorbidities. The proportion of patients admitted for acute stroke and inpatient rehabilitation facility care was analyzed graphically and using t test assuming unequal variances.
Results
The proportion of intracerebral hemorrhage patients (28.5% vs. 20.5%, P = 0.035) and those with history of transient ischemic attack (29% vs. 23.9%; P = 0.049) increased during the COVID-19 first wave in 2020. Uninsured acute stroke admissions decreased (7.3% vs. 16.6%) while commercially insured increased (42.7% vs. 33.4%, P < 0.001).
Acute stroke admissions decreased from 116.5 per month in 2019 to 98.8 per month in 2020 (P = 0.008) with no significant difference in inpatient rehabilitation facility admissions (39 per month in 2019, 34.5 per month in 2020; P = 0.66).
In 2019, monthly changes in acute stroke admissions coincided with inpatient rehabilitation facility admissions.
In 2020, acute stroke admissions decreased 80.6% from January to February, while inpatient rehabilitation facility admissions remained stable. Acute stroke admissions increased 12.8% in March 2020 and remained stable in April, while inpatient rehabilitation facility admissions decreased by 92%.
Conclusions
Acute stroke hospitalizations significantly decreased per month during the first wave of COVID-19, with a delayed effect on the transition from acute stroke to inpatient rehabilitation facility care.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Rehabilitation,Physical Therapy, Sports Therapy and Rehabilitation