Impact of Coronavirus Disease 2019 on Time Delay and Functional Outcome of Mechanical Thrombectomy in Tokyo, Japan,Journal of Stroke & Cerebrovascular Diseases

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Impact of Coronavirus Disease 2019 on Time Delay and Functional Outcome of Mechanical Thrombectomy in Tokyo, Japan
Journal of Stroke & Cerebrovascular Diseases ( IF 2.0 ) Pub Date : 2021-08-13 , DOI: 10.1016/j.jstrokecerebrovasdis.2021.106051
Masahiro Katsumata ₁ , Takahiro Ota ₂ , Junya Kaneko ₃ , Hiroyuki Jimbo ₄ , Rie Aoki ₅ , Shigeta Fujitani ₆ , Masahiko Ichijo ₇ , Masato Inoue ₈ , Keigo Shigeta ₉ , Yoshifumi Miyauchi ₁₀ , Yu Sakai ₁₁ , Hideki Arakawa ₁₂ , Yoshinobu Otsuka ₁₃ , Kenichi Ariyada ₁₄ , Yoshiaki Kuroshima ₁₅ , Takahisa Fuse ₁₆ , Yoshiaki Shiokawa ₁₇ , Teruyuki Hirano ₁₈

Affiliation

Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan.
Department of Neurosurgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
Department of Neurosurgery, Tokai University Hachioji Hospital, Tokyo, Japan.
Department of Endovascular Neurosurgery, Toranomon Hospital, Tokyo, Japan.
Department of Neurology, Musashino Red Cross Hospital, Tokyo, Japan.
Department of Neurosurgery, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
Department of Neurosurgery, National Hospital Organization Disaster Medical Center, Tokyo, Japan.
Department of Neurology, Showa University Koto Toyosu Hospital, Tokyo, Japan.
Department of Neurosurgery, Showa General Hospital, Tokyo, Japan.
Department of Neurosurgery, Omori Red Cross Hospital, Tokyo, Japan.
Department of Neurology, Machida Municipal Hospital, Tokyo, Japan.
Department of Neurosurgery, Tokyo Metropolitan Bokuto Hospital, Tokyo, Japan.
Department of Neurosurgery, Hino Municipal Hospital, Tokyo, Japan.
Department of Neurosurgery, Public Fussa Hospital, Tokyo, Japan.
Department of Neurosurgery, Kyorin University, Tokyo, Japan.
Department of Stroke and Cerebrovascular Medicine, Kyorin University, Tokyo, Japan.

Objectives

An association has been reported between delays in the onset-to-door (O2D) time for mechanical thrombectomy (MT) and outbreaks of coronavirus disease 2019 (COVID-19). However, the association between other MT time courses or functional outcomes and COVID-19 outbreaks remains unclear. We compared the time courses of stroke pathways or functional outcomes in 2020 (the COVID-19 era) with those in 2019 (the pre-COVID-19 era) in Tokyo, Japan.

Materials and methods

This retrospective observational study used data from the Tokyo-tama-REgistry of Acute endovascular Thrombectomy (TREAT), a multicenter registry of MT for acute large vessel occlusion in the Tokyo Metropolitan Area. Patients who had undergone acute MT from January 2019 to December 2020 were included. Patients were classified by the year they had undergone MT (2019 or 2020).

Results

In total, 477 patients were analyzed. O2D time was significantly longer in 2020 (146.0 min) than in 2019 (105.0 min; p = 0.034). No significant difference in door-to-puncture time (D2P) time or modified Rankin Scale (mRS) score 0–2 at 90 days was seen between 2019 and 2020. In the subgroup analysis, O2D time was significantly longer in the first half of 2020 compared with 2019. Multivariable logistic regression analysis revealed that the year 2020 was a independent predictor of longer O2D time, but not for mRS score 0–2 at 90 days.

Conclusions

Although O2D time was significantly longer in the COVID-19 compared with the pre-COVID-19 era, D2P may not be significantly delayed and functional outcomes may not be different, despite the COVID-19 pandemic.

中文翻译：

2019 冠状病毒病对日本东京机械血栓切除术的时间延迟和功能结果的影响

目标

据报道，机械血栓切除术 (MT) 的发病到上门 (O2D) 时间延迟与 2019 年冠状病毒病 (COVID-19) 爆发之间存在关联。然而，其他 MT 时间进程或功能结果与 COVID-19 爆发之间的关联仍不清楚。我们比较了日本东京 2020 年（COVID-19 时代）与 2019 年（COVID-19 前时代）中风通路或功能结果的时间进程。

材料和方法

这项回顾性观察研究使用了 Tokyo-tama-REGistry of Acute endovascular Thrombectomy (TREAT) 的数据，这是东京都市区急性大血管闭塞 MT 的多中心注册中心。纳入了 2019 年 1 月至 2020 年 12 月期间接受过急性 MT 的患者。患者按接受 MT 的年份（2019 年或 2020 年）进行分类。

结果

总共分析了 477 名患者。2020 年的 O2D 时间（146.0 分钟）明显长于 2019 年（105.0 分钟；p = 0.034）。2019 年和 2020 年之间，90 天的入院至穿刺时间 (D2P) 时间或改良 Rankin 量表 (mRS) 评分 0–2 无显着差异。在亚组分析中，O2D 时间在上半年明显更长2020 年与 2019 年相比。多变量逻辑回归分析显示，2020 年是较长 O2D 时间的独立预测因子，但不是 90 天时 mRS 评分 0-2 的独立预测因子。