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Temporal Trends of Ambulance Times for Suspected Stroke/Transient Ischemic Attack (TIA) Before and During the COVID-19 Pandemic in Ireland: A Retrospective Cohort Study
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Temporal Trends of Ambulance Times for Suspected Stroke/Transient Ischemic Attack (TIA) Before and During the COVID-19 Pandemic in Ireland: A Retrospective Cohort Study
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Temporal Trends of Ambulance Times for Suspected Stroke/Transient Ischemic Attack (TIA) Before and During the COVID-19 Pandemic in Ireland: A Retrospective Cohort Study
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Journal Article
Temporal Trends of Ambulance Times for Suspected Stroke/Transient Ischemic Attack (TIA) Before and During the COVID-19 Pandemic in Ireland: A Retrospective Cohort Study
2023
Overview
Introduction:International reports suggest there have been prehospital delays for time-sensitive emergencies like stroke and TIA during the COVID-19 pandemic. The aim was to investigate the impact of the COVID-19 pandemic on ambulance times and emergency call volume for adults with suspected stroke and TIA in Ireland.Method:We conducted a retrospective cohort study of patients ≥ 18 years with suspected stroke/TIA, based on data from the National Ambulance Service. We included all cases assigned code 28 (suspected stroke/TIA) by the emergency call-taker, from 2018-2021. We compared ambulance times and emergency call volume by week, the four COVID-19 waves (defined by the Health Protection Surveillance Centre) and annually. The COVID-19 period was from March 1, 2020 - December 19, 2021 and the pre-COVID-19 period January 1, 2018 - February 29, 2020. Continuous variables were compared with t-tests and categorical variables with Pearson’s χ2 tests.Results:40,012 cases were included: 20,281 in the pre-COVID-19 period and 19,731 in the COVID-19 period. Mean patient age significantly decreased between the two periods, from 71 years (±16.5) to 69.8 years (±17.1); p<0.001. Mean ambulance response time increased between the two periods from 17 minutes 31 seconds to 18 minutes 59 seconds (p<0.001). The number of cases with symptom onset to emergency call time of >4 hours significantly increased from 5,581 to 6,060 during the COVID-19 period (p<0.001). Mean calls/day increased from 25.1/day to 30.1/day during the COVID-19 period.Conclusion:Early findings from the study suggest an increase in call volume for stroke/TIA between the COVID-19 and pre-COVID-19 periods. An increase in response times during the same periods was also found. We concluded that longer symptom-to-call times indicate a change in healthcare-seeking behavior. Sustaining high levels of compliance with stroke code protocols is crucial during healthcare crises. Future research will involve further analysis including controlling for confounders.
Publisher
Cambridge University Press,Jems Publishing Company, Inc
