Acute stroke care in a New York City comprehensive stroke center during the COVID-19 pandemic.
Identifieur interne : 000957 ( Main/Exploration ); précédent : 000956; suivant : 000958Acute stroke care in a New York City comprehensive stroke center during the COVID-19 pandemic.
Auteurs : Shashank Agarwal [États-Unis] ; Erica Scher [États-Unis] ; Nirmala Rossan-Raghunath [États-Unis] ; Dilshad Marolia [États-Unis] ; Mariya Butnar [États-Unis] ; Jose Torres [États-Unis] ; Cen Zhang [États-Unis] ; Sun Kim [États-Unis] ; Matthew Sanger [États-Unis] ; Kelley Humbert [États-Unis] ; Omar Tanweer [États-Unis] ; Maksim Shapiro [États-Unis] ; Eytan Raz [États-Unis] ; Erez Nossek [États-Unis] ; Peter K. Nelson [États-Unis] ; Howard A. Riina [États-Unis] ; Adam De Havenon [États-Unis] ; Michael Wachs [États-Unis] ; Jeffrey Farkas [États-Unis] ; Ambooj Tiwari [États-Unis] ; Karthikeyan Arcot [États-Unis] ; David Turkel Parella [États-Unis] ; Jeremy Liff [États-Unis] ; Tina Wu [États-Unis] ; Ian Wittman [États-Unis] ; Reed Caldwell [États-Unis] ; Jennifer Frontera [États-Unis] ; Aaron Lord [États-Unis] ; Koto Ishida [États-Unis] ; Shadi Yaghi [États-Unis]Source :
- Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [ 1532-8511 ] ; 2020.
Descripteurs français
- KwdFr :
- Accident vasculaire cérébral (diagnostic), Accident vasculaire cérébral (thérapie), Accident vasculaire cérébral (épidémiologie), Adulte d'âge moyen (MeSH), Amélioration de la qualité (organisation et administration), Betacoronavirus (pathogénicité), Délai jusqu'au traitement (organisation et administration), Enregistrements (MeSH), Facteurs temps (MeSH), Femelle (MeSH), Flux de travaux (MeSH), Humains (MeSH), Indicateurs qualité santé (organisation et administration), Infections à coronavirus (diagnostic), Infections à coronavirus (thérapie), Infections à coronavirus (virologie), Infections à coronavirus (épidémiologie), Mâle (MeSH), New York (ville) (épidémiologie), Pandémies (MeSH), Pneumopathie virale (diagnostic), Pneumopathie virale (thérapie), Pneumopathie virale (virologie), Pneumopathie virale (épidémiologie), Prestation intégrée de soins de santé (organisation et administration), Programme clinique (organisation et administration), Résultat thérapeutique (MeSH), Services de santé polyvalents (organisation et administration), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Thrombectomie (MeSH), Traitement thrombolytique (MeSH), Équipe soignante (organisation et administration), Études rétrospectives (MeSH).
- MESH :
- diagnostic : Accident vasculaire cérébral, Infections à coronavirus, Pneumopathie virale.
- organisation et administration : Amélioration de la qualité, Délai jusqu'au traitement, Indicateurs qualité santé, Prestation intégrée de soins de santé, Programme clinique, Services de santé polyvalents, Équipe soignante.
- pathogénicité : Betacoronavirus.
- thérapie : Accident vasculaire cérébral, Infections à coronavirus, Pneumopathie virale.
- virologie : Infections à coronavirus, Pneumopathie virale.
- épidémiologie : Accident vasculaire cérébral, Infections à coronavirus, New York (ville), Pneumopathie virale.
- Adulte d'âge moyen, Enregistrements, Facteurs temps, Femelle, Flux de travaux, Humains, Mâle, Pandémies, Résultat thérapeutique, Sujet âgé, Sujet âgé de 80 ans ou plus, Thrombectomie, Traitement thrombolytique, Études rétrospectives.
English descriptors
- KwdEn :
- Aged (MeSH), Aged, 80 and over (MeSH), Betacoronavirus (pathogenicity), Comprehensive Health Care (organization & administration), Coronavirus Infections (diagnosis), Coronavirus Infections (epidemiology), Coronavirus Infections (therapy), Coronavirus Infections (virology), Critical Pathways (organization & administration), Delivery of Health Care, Integrated (organization & administration), Female (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), New York City (epidemiology), Pandemics (MeSH), Patient Care Team (organization & administration), Pneumonia, Viral (diagnosis), Pneumonia, Viral (epidemiology), Pneumonia, Viral (therapy), Pneumonia, Viral (virology), Quality Improvement (organization & administration), Quality Indicators, Health Care (organization & administration), Registries (MeSH), Retrospective Studies (MeSH), Stroke (diagnosis), Stroke (epidemiology), Stroke (therapy), Thrombectomy (MeSH), Thrombolytic Therapy (MeSH), Time Factors (MeSH), Time-to-Treatment (organization & administration), Treatment Outcome (MeSH), Workflow (MeSH).
- MESH :
- geographic , epidemiology : New York City.
- diagnosis : Coronavirus Infections, Pneumonia, Viral, Stroke.
- epidemiology : Coronavirus Infections, Pneumonia, Viral, Stroke.
- organization & administration : Comprehensive Health Care, Critical Pathways, Delivery of Health Care, Integrated, Patient Care Team, Quality Improvement, Quality Indicators, Health Care, Time-to-Treatment.
- pathogenicity : Betacoronavirus.
- therapy : Coronavirus Infections, Pneumonia, Viral, Stroke.
- virology : Coronavirus Infections, Pneumonia, Viral.
- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Pandemics, Registries, Retrospective Studies, Thrombectomy, Thrombolytic Therapy, Time Factors, Treatment Outcome, Workflow.
Abstract
BACKGROUND AND PURPOSE
The coronavirus disease-2019 (COVID-19) pandemic caused unprecedented demand and burden on emergency health care services in New York City. We aim to describe our experience providing acute stroke care at a comprehensive stroke center (CSC) and the impact of the pandemic on the quality of care for patients presenting with acute ischemic stroke (AIS).
METHODS
We retrospectively analyzed data from a quality improvement registry of consecutive AIS patients at New York University Langone Health's CSC between 06/01/2019-05/15/2020. During the early stages of the pandemic, the acute stroke process was modified to incorporate COVID-19 screening, testing, and other precautionary measures. We compared stroke quality metrics including treatment times and discharge outcomes of AIS patients during the pandemic (03/012020-05/152020) compared with a historical pre-pandemic group (6/1/2019-2/29/2020).
RESULTS
A total of 754 patients (pandemic-120; pre-pandemic-634) were admitted with a principal diagnosis of AIS; 198 (26.3%) received alteplase and/or mechanical thrombectomy. Despite longer median door to head CT times (16 vs 12 minutes; p = 0.05) and a trend towards longer door to groin puncture times (79.5 vs. 71 min, p = 0.06), the time to alteplase administration (36 vs 35 min; p = 0.83), door to reperfusion times (103 vs 97 min, p = 0.18) and defect-free care (95.2% vs 94.7%; p = 0.84) were similar in the pandemic and pre-pandemic groups. Successful recanalization rates (TICI≥2b) were also similar (82.6% vs. 86.7%, p = 0.48). After adjusting for stroke severity, age and a prior history of transient ischemic attack/stroke, pandemic patients had increased discharge mortality (adjusted OR 2.90 95% CI 1.77 - 7.17, p = 0.021) CONCLUSION: Despite unprecedented demands on emergency healthcare services, early multidisciplinary efforts to adapt the acute stroke treatment process resulted in keeping the stroke quality time metrics close to pre-pandemic levels. Future studies will be needed with a larger cohort comparing discharge and long-term outcomes between pre-pandemic and pandemic AIS patients.
DOI: 10.1016/j.jstrokecerebrovasdis.2020.105068
PubMed: 32807471
PubMed Central: PMC7305900
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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<author><name sortKey="Torres, Jose" sort="Torres, Jose" uniqKey="Torres J" first="Jose" last="Torres">Jose Torres</name>
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<author><name sortKey="Zhang, Cen" sort="Zhang, Cen" uniqKey="Zhang C" first="Cen" last="Zhang">Cen Zhang</name>
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<author><name sortKey="Kim, Sun" sort="Kim, Sun" uniqKey="Kim S" first="Sun" last="Kim">Sun Kim</name>
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<author><name sortKey="Sanger, Matthew" sort="Sanger, Matthew" uniqKey="Sanger M" first="Matthew" last="Sanger">Matthew Sanger</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Radiology, New York Langone Health, New York, NY</wicri:regionArea>
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<author><name sortKey="Riina, Howard A" sort="Riina, Howard A" uniqKey="Riina H" first="Howard A" last="Riina">Howard A. Riina</name>
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<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="De Havenon, Adam" sort="De Havenon, Adam" uniqKey="De Havenon A" first="Adam" last="De Havenon">Adam De Havenon</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, University of Utah, Salt Lake City, UT</wicri:regionArea>
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<author><name sortKey="Wachs, Michael" sort="Wachs, Michael" uniqKey="Wachs M" first="Michael" last="Wachs">Michael Wachs</name>
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<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="Farkas, Jeffrey" sort="Farkas, Jeffrey" uniqKey="Farkas J" first="Jeffrey" last="Farkas">Jeffrey Farkas</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
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<author><name sortKey="Tiwari, Ambooj" sort="Tiwari, Ambooj" uniqKey="Tiwari A" first="Ambooj" last="Tiwari">Ambooj Tiwari</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
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<author><name sortKey="Arcot, Karthikeyan" sort="Arcot, Karthikeyan" uniqKey="Arcot K" first="Karthikeyan" last="Arcot">Karthikeyan Arcot</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Karthikeyan.Arcot@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
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<author><name sortKey="Parella, David Turkel" sort="Parella, David Turkel" uniqKey="Parella D" first="David Turkel" last="Parella">David Turkel Parella</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: David.Turkel-Parrella@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
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<author><name sortKey="Liff, Jeremy" sort="Liff, Jeremy" uniqKey="Liff J" first="Jeremy" last="Liff">Jeremy Liff</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Jeremy.Liff@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Wu, Tina" sort="Wu, Tina" uniqKey="Wu T" first="Tina" last="Wu">Tina Wu</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Emergency Medicine, New York Langone Health, New York, NY, United States. Electronic address: Tina.Wu@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Emergency Medicine, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Wittman, Ian" sort="Wittman, Ian" uniqKey="Wittman I" first="Ian" last="Wittman">Ian Wittman</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Emergency Medicine, New York Langone Health, New York, NY, United States. Electronic address: Ian.Wittman@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Emergency Medicine, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Caldwell, Reed" sort="Caldwell, Reed" uniqKey="Caldwell R" first="Reed" last="Caldwell">Reed Caldwell</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Emergency Medicine, New York Langone Health, New York, NY, United States. Electronic address: Reed.Caldwell@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Emergency Medicine, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Frontera, Jennifer" sort="Frontera, Jennifer" uniqKey="Frontera J" first="Jennifer" last="Frontera">Jennifer Frontera</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Jennifer.Frontera@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lord, Aaron" sort="Lord, Aaron" uniqKey="Lord A" first="Aaron" last="Lord">Aaron Lord</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Aaron.Lord@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ishida, Koto" sort="Ishida, Koto" uniqKey="Ishida K" first="Koto" last="Ishida">Koto Ishida</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Koto.Ishida@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Yaghi, Shadi" sort="Yaghi, Shadi" uniqKey="Yaghi S" first="Shadi" last="Yaghi">Shadi Yaghi</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: shadiyaghi@yahoo.com.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
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</titleStmt>
<publicationStmt><idno type="wicri:source">PubMed</idno>
<date when="2020">2020</date>
<idno type="RBID">pubmed:32807471</idno>
<idno type="pmid">32807471</idno>
<idno type="doi">10.1016/j.jstrokecerebrovasdis.2020.105068</idno>
<idno type="pmc">PMC7305900</idno>
<idno type="wicri:Area/Main/Corpus">000606</idno>
<idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000606</idno>
<idno type="wicri:Area/Main/Curation">000606</idno>
<idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000606</idno>
<idno type="wicri:Area/Main/Exploration">000606</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en">Acute stroke care in a New York City comprehensive stroke center during the COVID-19 pandemic.</title>
<author><name sortKey="Agarwal, Shashank" sort="Agarwal, Shashank" uniqKey="Agarwal S" first="Shashank" last="Agarwal">Shashank Agarwal</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: shashank.agarwal@nyumc.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Scher, Erica" sort="Scher, Erica" uniqKey="Scher E" first="Erica" last="Scher">Erica Scher</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: erica.Scher@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Rossan Raghunath, Nirmala" sort="Rossan Raghunath, Nirmala" uniqKey="Rossan Raghunath N" first="Nirmala" last="Rossan-Raghunath">Nirmala Rossan-Raghunath</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Nirmala.Rossan-Raghunath@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Marolia, Dilshad" sort="Marolia, Dilshad" uniqKey="Marolia D" first="Dilshad" last="Marolia">Dilshad Marolia</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Dilshad.Marolia@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Butnar, Mariya" sort="Butnar, Mariya" uniqKey="Butnar M" first="Mariya" last="Butnar">Mariya Butnar</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Mariya.Butnar@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Torres, Jose" sort="Torres, Jose" uniqKey="Torres J" first="Jose" last="Torres">Jose Torres</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Jose.Torres2@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Zhang, Cen" sort="Zhang, Cen" uniqKey="Zhang C" first="Cen" last="Zhang">Cen Zhang</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Cen.Zhang@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kim, Sun" sort="Kim, Sun" uniqKey="Kim S" first="Sun" last="Kim">Sun Kim</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Sun.Kim@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sanger, Matthew" sort="Sanger, Matthew" uniqKey="Sanger M" first="Matthew" last="Sanger">Matthew Sanger</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Matt.Sanger@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Humbert, Kelley" sort="Humbert, Kelley" uniqKey="Humbert K" first="Kelley" last="Humbert">Kelley Humbert</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Kelley.Humbert@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Tanweer, Omar" sort="Tanweer, Omar" uniqKey="Tanweer O" first="Omar" last="Tanweer">Omar Tanweer</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurosurgery, New York Langone Health, New York, NY, United States. Electronic address: Omar.Tanweer@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurosurgery, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Shapiro, Maksim" sort="Shapiro, Maksim" uniqKey="Shapiro M" first="Maksim" last="Shapiro">Maksim Shapiro</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Radiology, New York Langone Health, New York, NY, United States. Electronic address: Maksim.Shapiro@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Radiology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Raz, Eytan" sort="Raz, Eytan" uniqKey="Raz E" first="Eytan" last="Raz">Eytan Raz</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Radiology, New York Langone Health, New York, NY, United States. Electronic address: Eytan.Raz@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Radiology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Nossek, Erez" sort="Nossek, Erez" uniqKey="Nossek E" first="Erez" last="Nossek">Erez Nossek</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurosurgery, New York Langone Health, New York, NY, United States. Electronic address: Erez.Nossek@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurosurgery, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Nelson, Peter K" sort="Nelson, Peter K" uniqKey="Nelson P" first="Peter K" last="Nelson">Peter K. Nelson</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Radiology, New York Langone Health, New York, NY, United States. Electronic address: Peter.Nelson@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Radiology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Riina, Howard A" sort="Riina, Howard A" uniqKey="Riina H" first="Howard A" last="Riina">Howard A. Riina</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurosurgery, New York Langone Health, New York, NY, United States. Electronic address: Howard.Riina@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurosurgery, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="De Havenon, Adam" sort="De Havenon, Adam" uniqKey="De Havenon A" first="Adam" last="De Havenon">Adam De Havenon</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, University of Utah, Salt Lake City, UT, United States. Electronic address: Adam.DeHavenon@hsc.utah.edu.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, University of Utah, Salt Lake City, UT</wicri:regionArea>
<placeName><region type="state">Utah</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Wachs, Michael" sort="Wachs, Michael" uniqKey="Wachs M" first="Michael" last="Wachs">Michael Wachs</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Michael.Wachs@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Farkas, Jeffrey" sort="Farkas, Jeffrey" uniqKey="Farkas J" first="Jeffrey" last="Farkas">Jeffrey Farkas</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Jeffrey.Farkas@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Tiwari, Ambooj" sort="Tiwari, Ambooj" uniqKey="Tiwari A" first="Ambooj" last="Tiwari">Ambooj Tiwari</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Ambooj.Tiwari@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Arcot, Karthikeyan" sort="Arcot, Karthikeyan" uniqKey="Arcot K" first="Karthikeyan" last="Arcot">Karthikeyan Arcot</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Karthikeyan.Arcot@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Parella, David Turkel" sort="Parella, David Turkel" uniqKey="Parella D" first="David Turkel" last="Parella">David Turkel Parella</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: David.Turkel-Parrella@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Liff, Jeremy" sort="Liff, Jeremy" uniqKey="Liff J" first="Jeremy" last="Liff">Jeremy Liff</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Jeremy.Liff@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Wu, Tina" sort="Wu, Tina" uniqKey="Wu T" first="Tina" last="Wu">Tina Wu</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Emergency Medicine, New York Langone Health, New York, NY, United States. Electronic address: Tina.Wu@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Emergency Medicine, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Wittman, Ian" sort="Wittman, Ian" uniqKey="Wittman I" first="Ian" last="Wittman">Ian Wittman</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Emergency Medicine, New York Langone Health, New York, NY, United States. Electronic address: Ian.Wittman@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Emergency Medicine, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Caldwell, Reed" sort="Caldwell, Reed" uniqKey="Caldwell R" first="Reed" last="Caldwell">Reed Caldwell</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Emergency Medicine, New York Langone Health, New York, NY, United States. Electronic address: Reed.Caldwell@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Emergency Medicine, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Frontera, Jennifer" sort="Frontera, Jennifer" uniqKey="Frontera J" first="Jennifer" last="Frontera">Jennifer Frontera</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Jennifer.Frontera@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lord, Aaron" sort="Lord, Aaron" uniqKey="Lord A" first="Aaron" last="Lord">Aaron Lord</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Aaron.Lord@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ishida, Koto" sort="Ishida, Koto" uniqKey="Ishida K" first="Koto" last="Ishida">Koto Ishida</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Koto.Ishida@nyulangone.org.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Yaghi, Shadi" sort="Yaghi, Shadi" uniqKey="Yaghi S" first="Shadi" last="Yaghi">Shadi Yaghi</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: shadiyaghi@yahoo.com.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, New York Langone Health, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association</title>
<idno type="eISSN">1532-8511</idno>
<imprint><date when="2020" type="published">2020</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Betacoronavirus (pathogenicity)</term>
<term>Comprehensive Health Care (organization & administration)</term>
<term>Coronavirus Infections (diagnosis)</term>
<term>Coronavirus Infections (epidemiology)</term>
<term>Coronavirus Infections (therapy)</term>
<term>Coronavirus Infections (virology)</term>
<term>Critical Pathways (organization & administration)</term>
<term>Delivery of Health Care, Integrated (organization & administration)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>New York City (epidemiology)</term>
<term>Pandemics (MeSH)</term>
<term>Patient Care Team (organization & administration)</term>
<term>Pneumonia, Viral (diagnosis)</term>
<term>Pneumonia, Viral (epidemiology)</term>
<term>Pneumonia, Viral (therapy)</term>
<term>Pneumonia, Viral (virology)</term>
<term>Quality Improvement (organization & administration)</term>
<term>Quality Indicators, Health Care (organization & administration)</term>
<term>Registries (MeSH)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Stroke (diagnosis)</term>
<term>Stroke (epidemiology)</term>
<term>Stroke (therapy)</term>
<term>Thrombectomy (MeSH)</term>
<term>Thrombolytic Therapy (MeSH)</term>
<term>Time Factors (MeSH)</term>
<term>Time-to-Treatment (organization & administration)</term>
<term>Treatment Outcome (MeSH)</term>
<term>Workflow (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Accident vasculaire cérébral (diagnostic)</term>
<term>Accident vasculaire cérébral (thérapie)</term>
<term>Accident vasculaire cérébral (épidémiologie)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Amélioration de la qualité (organisation et administration)</term>
<term>Betacoronavirus (pathogénicité)</term>
<term>Délai jusqu'au traitement (organisation et administration)</term>
<term>Enregistrements (MeSH)</term>
<term>Facteurs temps (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Flux de travaux (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Indicateurs qualité santé (organisation et administration)</term>
<term>Infections à coronavirus (diagnostic)</term>
<term>Infections à coronavirus (thérapie)</term>
<term>Infections à coronavirus (virologie)</term>
<term>Infections à coronavirus (épidémiologie)</term>
<term>Mâle (MeSH)</term>
<term>New York (ville) (épidémiologie)</term>
<term>Pandémies (MeSH)</term>
<term>Pneumopathie virale (diagnostic)</term>
<term>Pneumopathie virale (thérapie)</term>
<term>Pneumopathie virale (virologie)</term>
<term>Pneumopathie virale (épidémiologie)</term>
<term>Prestation intégrée de soins de santé (organisation et administration)</term>
<term>Programme clinique (organisation et administration)</term>
<term>Résultat thérapeutique (MeSH)</term>
<term>Services de santé polyvalents (organisation et administration)</term>
<term>Sujet âgé (MeSH)</term>
<term>Sujet âgé de 80 ans ou plus (MeSH)</term>
<term>Thrombectomie (MeSH)</term>
<term>Traitement thrombolytique (MeSH)</term>
<term>Équipe soignante (organisation et administration)</term>
<term>Études rétrospectives (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>New York City</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
<term>Stroke</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Accident vasculaire cérébral</term>
<term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
<term>Stroke</term>
</keywords>
<keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Amélioration de la qualité</term>
<term>Délai jusqu'au traitement</term>
<term>Indicateurs qualité santé</term>
<term>Prestation intégrée de soins de santé</term>
<term>Programme clinique</term>
<term>Services de santé polyvalents</term>
<term>Équipe soignante</term>
</keywords>
<keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Comprehensive Health Care</term>
<term>Critical Pathways</term>
<term>Delivery of Health Care, Integrated</term>
<term>Patient Care Team</term>
<term>Quality Improvement</term>
<term>Quality Indicators, Health Care</term>
<term>Time-to-Treatment</term>
</keywords>
<keywords scheme="MESH" qualifier="pathogenicity" xml:lang="en"><term>Betacoronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="pathogénicité" xml:lang="fr"><term>Betacoronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
<term>Stroke</term>
</keywords>
<keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Accident vasculaire cérébral</term>
<term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Accident vasculaire cérébral</term>
<term>Infections à coronavirus</term>
<term>New York (ville)</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Aged, 80 and over</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Pandemics</term>
<term>Registries</term>
<term>Retrospective Studies</term>
<term>Thrombectomy</term>
<term>Thrombolytic Therapy</term>
<term>Time Factors</term>
<term>Treatment Outcome</term>
<term>Workflow</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Enregistrements</term>
<term>Facteurs temps</term>
<term>Femelle</term>
<term>Flux de travaux</term>
<term>Humains</term>
<term>Mâle</term>
<term>Pandémies</term>
<term>Résultat thérapeutique</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Thrombectomie</term>
<term>Traitement thrombolytique</term>
<term>Études rétrospectives</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND AND PURPOSE</b>
</p>
<p>The coronavirus disease-2019 (COVID-19) pandemic caused unprecedented demand and burden on emergency health care services in New York City. We aim to describe our experience providing acute stroke care at a comprehensive stroke center (CSC) and the impact of the pandemic on the quality of care for patients presenting with acute ischemic stroke (AIS).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>We retrospectively analyzed data from a quality improvement registry of consecutive AIS patients at New York University Langone Health's CSC between 06/01/2019-05/15/2020. During the early stages of the pandemic, the acute stroke process was modified to incorporate COVID-19 screening, testing, and other precautionary measures. We compared stroke quality metrics including treatment times and discharge outcomes of AIS patients during the pandemic (03/012020-05/152020) compared with a historical pre-pandemic group (6/1/2019-2/29/2020).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>A total of 754 patients (pandemic-120; pre-pandemic-634) were admitted with a principal diagnosis of AIS; 198 (26.3%) received alteplase and/or mechanical thrombectomy. Despite longer median door to head CT times (16 vs 12 minutes; p = 0.05) and a trend towards longer door to groin puncture times (79.5 vs. 71 min, p = 0.06), the time to alteplase administration (36 vs 35 min; p = 0.83), door to reperfusion times (103 vs 97 min, p = 0.18) and defect-free care (95.2% vs 94.7%; p = 0.84) were similar in the pandemic and pre-pandemic groups. Successful recanalization rates (TICI≥2b) were also similar (82.6% vs. 86.7%, p = 0.48). After adjusting for stroke severity, age and a prior history of transient ischemic attack/stroke, pandemic patients had increased discharge mortality (adjusted OR 2.90 95% CI 1.77 - 7.17, p = 0.021) CONCLUSION: Despite unprecedented demands on emergency healthcare services, early multidisciplinary efforts to adapt the acute stroke treatment process resulted in keeping the stroke quality time metrics close to pre-pandemic levels. Future studies will be needed with a larger cohort comparing discharge and long-term outcomes between pre-pandemic and pandemic AIS patients.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32807471</PMID>
<DateCompleted><Year>2020</Year>
<Month>08</Month>
<Day>24</Day>
</DateCompleted>
<DateRevised><Year>2020</Year>
<Month>10</Month>
<Day>03</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1532-8511</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>29</Volume>
<Issue>9</Issue>
<PubDate><Year>2020</Year>
<Month>Sep</Month>
</PubDate>
</JournalIssue>
<Title>Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association</Title>
<ISOAbbreviation>J Stroke Cerebrovasc Dis</ISOAbbreviation>
</Journal>
<ArticleTitle>Acute stroke care in a New York City comprehensive stroke center during the COVID-19 pandemic.</ArticleTitle>
<Pagination><MedlinePgn>105068</MedlinePgn>
</Pagination>
<ELocationID EIdType="pii" ValidYN="Y">S1052-3057(20)30486-9</ELocationID>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jstrokecerebrovasdis.2020.105068</ELocationID>
<Abstract><AbstractText Label="BACKGROUND AND PURPOSE" NlmCategory="OBJECTIVE">The coronavirus disease-2019 (COVID-19) pandemic caused unprecedented demand and burden on emergency health care services in New York City. We aim to describe our experience providing acute stroke care at a comprehensive stroke center (CSC) and the impact of the pandemic on the quality of care for patients presenting with acute ischemic stroke (AIS).</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">We retrospectively analyzed data from a quality improvement registry of consecutive AIS patients at New York University Langone Health's CSC between 06/01/2019-05/15/2020. During the early stages of the pandemic, the acute stroke process was modified to incorporate COVID-19 screening, testing, and other precautionary measures. We compared stroke quality metrics including treatment times and discharge outcomes of AIS patients during the pandemic (03/012020-05/152020) compared with a historical pre-pandemic group (6/1/2019-2/29/2020).</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 754 patients (pandemic-120; pre-pandemic-634) were admitted with a principal diagnosis of AIS; 198 (26.3%) received alteplase and/or mechanical thrombectomy. Despite longer median door to head CT times (16 vs 12 minutes; p = 0.05) and a trend towards longer door to groin puncture times (79.5 vs. 71 min, p = 0.06), the time to alteplase administration (36 vs 35 min; p = 0.83), door to reperfusion times (103 vs 97 min, p = 0.18) and defect-free care (95.2% vs 94.7%; p = 0.84) were similar in the pandemic and pre-pandemic groups. Successful recanalization rates (TICI≥2b) were also similar (82.6% vs. 86.7%, p = 0.48). After adjusting for stroke severity, age and a prior history of transient ischemic attack/stroke, pandemic patients had increased discharge mortality (adjusted OR 2.90 95% CI 1.77 - 7.17, p = 0.021) CONCLUSION: Despite unprecedented demands on emergency healthcare services, early multidisciplinary efforts to adapt the acute stroke treatment process resulted in keeping the stroke quality time metrics close to pre-pandemic levels. Future studies will be needed with a larger cohort comparing discharge and long-term outcomes between pre-pandemic and pandemic AIS patients.</AbstractText>
<CopyrightInformation>Copyright © 2020 Elsevier Inc. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Agarwal</LastName>
<ForeName>Shashank</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: shashank.agarwal@nyumc.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Scher</LastName>
<ForeName>Erica</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: erica.Scher@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rossan-Raghunath</LastName>
<ForeName>Nirmala</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Nirmala.Rossan-Raghunath@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Marolia</LastName>
<ForeName>Dilshad</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Dilshad.Marolia@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Butnar</LastName>
<ForeName>Mariya</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Mariya.Butnar@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Torres</LastName>
<ForeName>Jose</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Jose.Torres2@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zhang</LastName>
<ForeName>Cen</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Cen.Zhang@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Kim</LastName>
<ForeName>Sun</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Sun.Kim@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sanger</LastName>
<ForeName>Matthew</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Matt.Sanger@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Humbert</LastName>
<ForeName>Kelley</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Kelley.Humbert@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Tanweer</LastName>
<ForeName>Omar</ForeName>
<Initials>O</Initials>
<AffiliationInfo><Affiliation>Department of Neurosurgery, New York Langone Health, New York, NY, United States. Electronic address: Omar.Tanweer@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Shapiro</LastName>
<ForeName>Maksim</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Radiology, New York Langone Health, New York, NY, United States. Electronic address: Maksim.Shapiro@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Raz</LastName>
<ForeName>Eytan</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Department of Radiology, New York Langone Health, New York, NY, United States. Electronic address: Eytan.Raz@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Nossek</LastName>
<ForeName>Erez</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Department of Neurosurgery, New York Langone Health, New York, NY, United States. Electronic address: Erez.Nossek@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Nelson</LastName>
<ForeName>Peter K</ForeName>
<Initials>PK</Initials>
<AffiliationInfo><Affiliation>Department of Radiology, New York Langone Health, New York, NY, United States. Electronic address: Peter.Nelson@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Riina</LastName>
<ForeName>Howard A</ForeName>
<Initials>HA</Initials>
<AffiliationInfo><Affiliation>Department of Neurosurgery, New York Langone Health, New York, NY, United States. Electronic address: Howard.Riina@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>de Havenon</LastName>
<ForeName>Adam</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, University of Utah, Salt Lake City, UT, United States. Electronic address: Adam.DeHavenon@hsc.utah.edu.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Wachs</LastName>
<ForeName>Michael</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Michael.Wachs@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Farkas</LastName>
<ForeName>Jeffrey</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Jeffrey.Farkas@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Tiwari</LastName>
<ForeName>Ambooj</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Ambooj.Tiwari@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Arcot</LastName>
<ForeName>Karthikeyan</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Karthikeyan.Arcot@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Parella</LastName>
<ForeName>David Turkel</ForeName>
<Initials>DT</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: David.Turkel-Parrella@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Liff</LastName>
<ForeName>Jeremy</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Jeremy.Liff@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Wu</LastName>
<ForeName>Tina</ForeName>
<Initials>T</Initials>
<AffiliationInfo><Affiliation>Department of Emergency Medicine, New York Langone Health, New York, NY, United States. Electronic address: Tina.Wu@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Wittman</LastName>
<ForeName>Ian</ForeName>
<Initials>I</Initials>
<AffiliationInfo><Affiliation>Department of Emergency Medicine, New York Langone Health, New York, NY, United States. Electronic address: Ian.Wittman@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Caldwell</LastName>
<ForeName>Reed</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Department of Emergency Medicine, New York Langone Health, New York, NY, United States. Electronic address: Reed.Caldwell@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Frontera</LastName>
<ForeName>Jennifer</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Jennifer.Frontera@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lord</LastName>
<ForeName>Aaron</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Aaron.Lord@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ishida</LastName>
<ForeName>Koto</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: Koto.Ishida@nyulangone.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Yaghi</LastName>
<ForeName>Shadi</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, New York Langone Health, New York, NY, United States. Electronic address: shadiyaghi@yahoo.com.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2020</Year>
<Month>06</Month>
<Day>20</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>J Stroke Cerebrovasc Dis</MedlineTA>
<NlmUniqueID>9111633</NlmUniqueID>
<ISSNLinking>1052-3057</ISSNLinking>
</MedlineJournalInfo>
<SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName>
<SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName>
</SupplMeshList>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName>
<QualifierName UI="Q000472" MajorTopicYN="Y">pathogenicity</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D003191" MajorTopicYN="N">Comprehensive Health Care</DescriptorName>
<QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D019091" MajorTopicYN="N">Critical Pathways</DescriptorName>
<QualifierName UI="Q000458" MajorTopicYN="N">organization & administration</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D019033" MajorTopicYN="N">Delivery of Health Care, Integrated</DescriptorName>
<QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D009519" MajorTopicYN="N" Type="Geographic">New York City</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D010348" MajorTopicYN="N">Patient Care Team</DescriptorName>
<QualifierName UI="Q000458" MajorTopicYN="N">organization & administration</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D058996" MajorTopicYN="N">Quality Improvement</DescriptorName>
<QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D019984" MajorTopicYN="N">Quality Indicators, Health Care</DescriptorName>
<QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012042" MajorTopicYN="N">Registries</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D020521" MajorTopicYN="N">Stroke</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017131" MajorTopicYN="Y">Thrombectomy</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015912" MajorTopicYN="Y">Thrombolytic Therapy</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D061665" MajorTopicYN="N">Time-to-Treatment</DescriptorName>
<QualifierName UI="Q000458" MajorTopicYN="N">organization & administration</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D057188" MajorTopicYN="N">Workflow</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword>
<Keyword MajorTopicYN="N">Comprehensive stroke center</Keyword>
<Keyword MajorTopicYN="N">Quality research</Keyword>
<Keyword MajorTopicYN="N">Stroke</Keyword>
</KeywordList>
<CoiStatement>Declaration of Competing Interest None.</CoiStatement>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year>
<Month>05</Month>
<Day>29</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised"><Year>2020</Year>
<Month>06</Month>
<Day>10</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2020</Year>
<Month>06</Month>
<Day>15</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez"><Year>2020</Year>
<Month>8</Month>
<Day>19</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed"><Year>2020</Year>
<Month>8</Month>
<Day>19</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2020</Year>
<Month>8</Month>
<Day>25</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">32807471</ArticleId>
<ArticleId IdType="pii">S1052-3057(20)30486-9</ArticleId>
<ArticleId IdType="doi">10.1016/j.jstrokecerebrovasdis.2020.105068</ArticleId>
<ArticleId IdType="pmc">PMC7305900</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Utah</li>
<li>État de New York</li>
</region>
</list>
<tree><country name="États-Unis"><region name="État de New York"><name sortKey="Agarwal, Shashank" sort="Agarwal, Shashank" uniqKey="Agarwal S" first="Shashank" last="Agarwal">Shashank Agarwal</name>
</region>
<name sortKey="Arcot, Karthikeyan" sort="Arcot, Karthikeyan" uniqKey="Arcot K" first="Karthikeyan" last="Arcot">Karthikeyan Arcot</name>
<name sortKey="Butnar, Mariya" sort="Butnar, Mariya" uniqKey="Butnar M" first="Mariya" last="Butnar">Mariya Butnar</name>
<name sortKey="Caldwell, Reed" sort="Caldwell, Reed" uniqKey="Caldwell R" first="Reed" last="Caldwell">Reed Caldwell</name>
<name sortKey="De Havenon, Adam" sort="De Havenon, Adam" uniqKey="De Havenon A" first="Adam" last="De Havenon">Adam De Havenon</name>
<name sortKey="Farkas, Jeffrey" sort="Farkas, Jeffrey" uniqKey="Farkas J" first="Jeffrey" last="Farkas">Jeffrey Farkas</name>
<name sortKey="Frontera, Jennifer" sort="Frontera, Jennifer" uniqKey="Frontera J" first="Jennifer" last="Frontera">Jennifer Frontera</name>
<name sortKey="Humbert, Kelley" sort="Humbert, Kelley" uniqKey="Humbert K" first="Kelley" last="Humbert">Kelley Humbert</name>
<name sortKey="Ishida, Koto" sort="Ishida, Koto" uniqKey="Ishida K" first="Koto" last="Ishida">Koto Ishida</name>
<name sortKey="Kim, Sun" sort="Kim, Sun" uniqKey="Kim S" first="Sun" last="Kim">Sun Kim</name>
<name sortKey="Liff, Jeremy" sort="Liff, Jeremy" uniqKey="Liff J" first="Jeremy" last="Liff">Jeremy Liff</name>
<name sortKey="Lord, Aaron" sort="Lord, Aaron" uniqKey="Lord A" first="Aaron" last="Lord">Aaron Lord</name>
<name sortKey="Marolia, Dilshad" sort="Marolia, Dilshad" uniqKey="Marolia D" first="Dilshad" last="Marolia">Dilshad Marolia</name>
<name sortKey="Nelson, Peter K" sort="Nelson, Peter K" uniqKey="Nelson P" first="Peter K" last="Nelson">Peter K. Nelson</name>
<name sortKey="Nossek, Erez" sort="Nossek, Erez" uniqKey="Nossek E" first="Erez" last="Nossek">Erez Nossek</name>
<name sortKey="Parella, David Turkel" sort="Parella, David Turkel" uniqKey="Parella D" first="David Turkel" last="Parella">David Turkel Parella</name>
<name sortKey="Raz, Eytan" sort="Raz, Eytan" uniqKey="Raz E" first="Eytan" last="Raz">Eytan Raz</name>
<name sortKey="Riina, Howard A" sort="Riina, Howard A" uniqKey="Riina H" first="Howard A" last="Riina">Howard A. Riina</name>
<name sortKey="Rossan Raghunath, Nirmala" sort="Rossan Raghunath, Nirmala" uniqKey="Rossan Raghunath N" first="Nirmala" last="Rossan-Raghunath">Nirmala Rossan-Raghunath</name>
<name sortKey="Sanger, Matthew" sort="Sanger, Matthew" uniqKey="Sanger M" first="Matthew" last="Sanger">Matthew Sanger</name>
<name sortKey="Scher, Erica" sort="Scher, Erica" uniqKey="Scher E" first="Erica" last="Scher">Erica Scher</name>
<name sortKey="Shapiro, Maksim" sort="Shapiro, Maksim" uniqKey="Shapiro M" first="Maksim" last="Shapiro">Maksim Shapiro</name>
<name sortKey="Tanweer, Omar" sort="Tanweer, Omar" uniqKey="Tanweer O" first="Omar" last="Tanweer">Omar Tanweer</name>
<name sortKey="Tiwari, Ambooj" sort="Tiwari, Ambooj" uniqKey="Tiwari A" first="Ambooj" last="Tiwari">Ambooj Tiwari</name>
<name sortKey="Torres, Jose" sort="Torres, Jose" uniqKey="Torres J" first="Jose" last="Torres">Jose Torres</name>
<name sortKey="Wachs, Michael" sort="Wachs, Michael" uniqKey="Wachs M" first="Michael" last="Wachs">Michael Wachs</name>
<name sortKey="Wittman, Ian" sort="Wittman, Ian" uniqKey="Wittman I" first="Ian" last="Wittman">Ian Wittman</name>
<name sortKey="Wu, Tina" sort="Wu, Tina" uniqKey="Wu T" first="Tina" last="Wu">Tina Wu</name>
<name sortKey="Yaghi, Shadi" sort="Yaghi, Shadi" uniqKey="Yaghi S" first="Shadi" last="Yaghi">Shadi Yaghi</name>
<name sortKey="Zhang, Cen" sort="Zhang, Cen" uniqKey="Zhang C" first="Cen" last="Zhang">Cen Zhang</name>
</country>
</tree>
</affiliations>
</record>
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