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Delays in Intracerebral Hemorrhage Management Is Associated with Hematoma Expansion and Worse Outcomes: Changes in COVID-19 Era

Authors
 Hyun Jin Han  ;  Keun Young Park  ;  Junhyung Kim  ;  Woosung Lee  ;  Yun Ho Lee  ;  Chang Ki Jang  ;  Kwang-Chun Cho  ;  Sang Kyu Park  ;  Joonho Chung  ;  Young Sub Kwon  ;  Yong Bae Kim  ;  Jae Whan Lee  ;  So Yeon Kim 
Citation
 YONSEI MEDICAL JOURNAL, Vol.62(10) : 911-917, 2021-10 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2021-10
MeSH
COVID-19* ; Cerebral Hemorrhage / epidemiology ; Cerebral Hemorrhage / therapy ; Hematoma / epidemiology ; Hematoma / therapy ; Humans ; Retrospective Studies ; SARS-CoV-2
Keywords
COVID-19 ; hemorrhage ; incidence ; stroke
Abstract
Purpose: The coronavirus disease 2019 (COVID-19) pandemic disrupted the emergency medical care system worldwide. We analyzed the changes in the management of intracerebral hemorrhage (ICH) and compared the pre-COVID-19 and COVID-19 eras.

Materials and methods: From March to October of the COVID-19 era (2020), 83 consecutive patients with ICH were admitted to four comprehensive stroke centers. We retrospectively reviewed the data of patients and compared the treatment workflow metrics, treatment modalities, and clinical outcomes with the patients admitted during the same period of pre-COVID-19 era (2017-2019).

Results: Three hundred thirty-eight patients (83 in COVID-19 era and 255 in pre-COVID-19 era) were included in this study. Symptom onset/detection-to-door time [COVID-19; 56.0 min (34.0-106.0), pre-COVID-19; 40.0 min (27.0-98.0), p=0.016] and median door to-intensive treatment time differed between the two groups [COVID-19; 349.0 min (177.0-560.0), pre-COVID-19; 184.0 min (134.0-271.0), p<0.001]. Hematoma expansion was detected more significantly in the COVID-19 era (39.8% vs. 22.1%, p=0.002). At 3-month follow-up, clinical outcomes of patients were worse in the COVID-19 era (Good modified Rankin Scale; 33.7% in COVID19, 46.7% in pre-COVID-19, p=0.039).

Conclusion: During the COVID-19 era, delays in management of ICH was associated with hematoma expansion and worse outcomes.
Files in This Item:
T202104910.pdf Download
DOI
10.3349/ymj.2021.62.10.911
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0003-2262-7157
Kim, Junhyung(김준형) ORCID logo https://orcid.org/0000-0002-8908-978X
Park, Keun Young(박근영)
Park, Sang Kyu(박상규)
Lee, Woo Sung(이우성)
Lee, Jae Whan(이재환)
Jang, Chang Ki(장창기) ORCID logo https://orcid.org/0000-0001-8715-8844
Chung, Joon Ho(정준호)
Han, Hyun Jin(한현진) ORCID logo https://orcid.org/0000-0002-4111-4819
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/186993
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