Trends in Intensive Care Admissions and Outcomes of Stroke Patients Over 10 Years in Brazil: Impact of the COVID-19 Pandemic

Detalhes bibliográficos
Autor(a) principal: Kurtz, Pedro
Data de Publicação: 2023
Outros Autores: Bastos, Leonardo S. L., Zampieri, Fernando G., Freitas, Gabriel R. de, Bozza, Fernando A., Soares, Marcio, Salluh, Jorge I. F.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/58218
Resumo: Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
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spelling Kurtz, PedroBastos, Leonardo S. L.Zampieri, Fernando G.Freitas, Gabriel R. deBozza, Fernando A.Soares, MarcioSalluh, Jorge I. F.2023-05-09T02:32:56Z2023-05-09T02:32:56Z2023KURTZ, Pedro et al. Trends in intensive care admissions and outcomes of stroke patients Over 10 years in Brazil: impact of the COVID-19 pandemic. Chest, v. 163, n. 3, p. 543-553, Mar. 2023.0012-3692https://www.arca.fiocruz.br/handle/icict/5821810.1016/j.chest.2022.10.0331931-3543Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brasil / Hospital Copa Star. Rio de Janeiro, RJ, Brasil / Paulo Niemeyer State Brain Institute. Rio de Janeiro, RJ, Brasil.Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brasil.Hospital Vila Nova Star. Department of Critical Care Medicine. Intensive Care Unit. São Paulo, SP, Brasil / University of Alberta. Faculty of Medicine and Dentistry. Edmonton, AB, Canada.D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brasil / Universidade Federal Fluminense. Department of Neurology. Niterói, RJ, Brasil.D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brasil / Oswaldo Cruz Foundation. National Institute of Infectious Disease Evandro Chagas. Rio de Janeiro, RJ, Brasil.D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brasil.D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brasil / Federal University of Rio de Janeiro. Postgraduate Program of Internal Medicine. Rio de Janeiro, RJ, Brasil.Background: The coronavirus 2019 (COVID-19) pandemic affected stroke care worldwide. Data from low- and middle-income countries are limited. Research question: What was the impact of the pandemic in ICU admissions and outcomes of patients with stroke, in comparison with trends over the last 10 years? Study design and methods: Retrospective cohort study including prospectively collected data from 165 ICUs in Brazil between 2011 and 2020. We analyzed clinical characteristics and mortality over a period of 10 years and evaluated the impact of the pandemic on stroke outcomes, using the following approach: analyses of admissions for ischemic and hemorrhagic strokes and trends in in-hospital mortality over 10 years; analysis of variable life-adjusted display (VLAD) during 2020; and a mixed-effects multivariable logistic regression model. Results: A total of 17,115 stroke admissions were analyzed, from which 13,634 were ischemic and 3,481 were hemorrhagic. In-hospital mortality was lower after ischemic stroke as compared with hemorrhagic (9% vs 24%, respectively). Changes in VLAD across epidemiological weeks of 2020 showed that the rise in COVID-19 cases was accompanied by increased mortality, mainly after ischemic stroke. In logistic regression mixed models, mortality was higher in 2020 compared with 2019, 2018, and 2017 in patients with ischemic stroke, namely, in those without altered mental status. In hemorrhagic stroke, the increased mortality in 2020 was observed in patients 50 years of age or younger, as compared with 2019. Interpretation: Hospital outcomes of stroke admissions worsened during the COVID-19 pandemic, interrupting a trend of improvements in survival rates over 10 years. This effect was more pronounced during the surge of COVID-19 ICU admissions affecting predominantly patients with ischemic stroke without coma, and young patients with hemorrhagic stroke.engAmerican College of Chest Physicianshttps://www.arca.fiocruz.br/handle/icict/57335Coronavírus 2019Pandemia de COVID-19HemorragiaIsquemiaResultadosAVCCoronavirus 2019COVID-19 pandemicHemorrhagicIschemicOutcomesStrokeTrends in Intensive Care Admissions and Outcomes of Stroke Patients Over 10 Years in Brazil: Impact of the COVID-19 Pandemicinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; 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dc.title.en_US.fl_str_mv Trends in Intensive Care Admissions and Outcomes of Stroke Patients Over 10 Years in Brazil: Impact of the COVID-19 Pandemic
title Trends in Intensive Care Admissions and Outcomes of Stroke Patients Over 10 Years in Brazil: Impact of the COVID-19 Pandemic
spellingShingle Trends in Intensive Care Admissions and Outcomes of Stroke Patients Over 10 Years in Brazil: Impact of the COVID-19 Pandemic
Kurtz, Pedro
Coronavírus 2019
Pandemia de COVID-19
Hemorragia
Isquemia
Resultados
AVC
Coronavirus 2019
COVID-19 pandemic
Hemorrhagic
Ischemic
Outcomes
Stroke
title_short Trends in Intensive Care Admissions and Outcomes of Stroke Patients Over 10 Years in Brazil: Impact of the COVID-19 Pandemic
title_full Trends in Intensive Care Admissions and Outcomes of Stroke Patients Over 10 Years in Brazil: Impact of the COVID-19 Pandemic
title_fullStr Trends in Intensive Care Admissions and Outcomes of Stroke Patients Over 10 Years in Brazil: Impact of the COVID-19 Pandemic
title_full_unstemmed Trends in Intensive Care Admissions and Outcomes of Stroke Patients Over 10 Years in Brazil: Impact of the COVID-19 Pandemic
title_sort Trends in Intensive Care Admissions and Outcomes of Stroke Patients Over 10 Years in Brazil: Impact of the COVID-19 Pandemic
author Kurtz, Pedro
author_facet Kurtz, Pedro
Bastos, Leonardo S. L.
Zampieri, Fernando G.
Freitas, Gabriel R. de
Bozza, Fernando A.
Soares, Marcio
Salluh, Jorge I. F.
author_role author
author2 Bastos, Leonardo S. L.
Zampieri, Fernando G.
Freitas, Gabriel R. de
Bozza, Fernando A.
Soares, Marcio
Salluh, Jorge I. F.
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Kurtz, Pedro
Bastos, Leonardo S. L.
Zampieri, Fernando G.
Freitas, Gabriel R. de
Bozza, Fernando A.
Soares, Marcio
Salluh, Jorge I. F.
dc.subject.other.en_US.fl_str_mv Coronavírus 2019
Pandemia de COVID-19
Hemorragia
Isquemia
Resultados
AVC
topic Coronavírus 2019
Pandemia de COVID-19
Hemorragia
Isquemia
Resultados
AVC
Coronavirus 2019
COVID-19 pandemic
Hemorrhagic
Ischemic
Outcomes
Stroke
dc.subject.en.en_US.fl_str_mv Coronavirus 2019
COVID-19 pandemic
Hemorrhagic
Ischemic
Outcomes
Stroke
description Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
publishDate 2023
dc.date.accessioned.fl_str_mv 2023-05-09T02:32:56Z
dc.date.available.fl_str_mv 2023-05-09T02:32:56Z
dc.date.issued.fl_str_mv 2023
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.citation.fl_str_mv KURTZ, Pedro et al. Trends in intensive care admissions and outcomes of stroke patients Over 10 years in Brazil: impact of the COVID-19 pandemic. Chest, v. 163, n. 3, p. 543-553, Mar. 2023.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/58218
dc.identifier.issn.en_US.fl_str_mv 0012-3692
dc.identifier.doi.none.fl_str_mv 10.1016/j.chest.2022.10.033
dc.identifier.eissn.none.fl_str_mv 1931-3543
identifier_str_mv KURTZ, Pedro et al. Trends in intensive care admissions and outcomes of stroke patients Over 10 years in Brazil: impact of the COVID-19 pandemic. Chest, v. 163, n. 3, p. 543-553, Mar. 2023.
0012-3692
10.1016/j.chest.2022.10.033
1931-3543
url https://www.arca.fiocruz.br/handle/icict/58218
dc.language.iso.fl_str_mv eng
language eng
dc.relation.isversionof.en_US.fl_str_mv https://www.arca.fiocruz.br/handle/icict/57335
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv American College of Chest Physicians
publisher.none.fl_str_mv American College of Chest Physicians
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
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collection Repositório Institucional da FIOCRUZ (ARCA)
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