Universidad del Desarrollo

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Abstract P385: Stroke-Related Hospital Admissions During Covid-19 Pandemic in the Latin American Stroke Registry (LASE)
(2021)
Virginia Pujol-Lereis
;
Alan Flores
;
Antonio Arauz
;
Carlos Abanto-Argomedo
;
Pablo Amaya
<jats:p> <jats:bold>Background:</jats:bold> COVID-19 pandemic has forced important changes in health care worldwide. Stroke care networks have been affected, especially acute admissions and ancillary tests availability. We assessed the impact of the pandemic and the lockdowns imposed in stroke admissions in Latin America. </jats:p> <jats:p> <jats:bold>Methods:</jats:bold> A multinational study (7 countries, 18 centers) of patients admitted since the pandemic outbreak (January - June 2020). These cases were compared with the same period in 2019. We also assessed patterns during the strictest lockdown period (March-June 2020). Number of cases, stroke etiology and severity, acute care and functional outcomes were compared per periods, months, centers and countries. </jats:p> <jats:p> <jats:bold>Results:</jats:bold> There were 1863 stroke cases in 2019 and 1781 cases in 2020 (p=0.02). We found a significant increase in strokes of undetermined etiology due to incomplete studies in 2020 [16.8% vs 27.6%, p<0.001]). Most countries reported decreases in all-type stroke admissions, except México and Brasil (16% and 36% increases in admissions, respectively). There were no significant differences among months. All-type mortality increased (6.2% vs. 12.6%, p<0.001), and poor functional outcome (mRs 3-6) increased from 32.2% to 38.8% (p=0.007) in 2020. During the period of strict lockdown (March-June 2020), ischemic stroke admissions during the first 24 hours of onset (68.3% vs. 64.4%, p=0.1) and in-hospital stroke code activation (35.1% vs. 27.6%, p=0.005) diminished compared to 2019 period. No differences in total reperfusion treatment rates were observed, with similar door-to-needle and door-to-groin times in both periods. </jats:p> <jats:p> <jats:bold>Conclusions:</jats:bold> All-type stroke admissions diminished only slightly during the first months of the COVID-19 pandemic. However, in this region, we found substantial deficiencies in stroke work-up, poor short-term outcome and increased mortality. </jats:p>
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Fighting Against Stroke in Latin America: A Joint Effort of Medical Professional Societies and Governments
(2021)
Sheila Cristina Ouriques Martins
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LAVADOS GERMAIN, PABLO MANUEL
;
Thaís Leite Secchi
;
Michael Brainin
;
Sebastian Ameriso
<jats:p><jats:bold>Introduction:</jats:bold> Stroke is one of the leading causes of death in Latin America, a region with countless gaps to be addressed to decrease its burden. In 2018, at the first Latin American Stroke Ministerial Meeting, stroke physician and healthcare manager representatives from 13 countries signed the Declaration of Gramado with the priorities to improve the region, with the commitment to implement all evidence-based strategies for stroke care. The second meeting in March 2020 reviewed the achievements in 2 years and discussed new objectives. This paper will review the 2-year advances and future plans of the Latin American alliance for stroke.</jats:p><jats:p><jats:bold>Method:</jats:bold> In March 2020, a survey based on the Declaration of Gramado items was sent to the neurologists participants of the Stroke Ministerial Meetings. The results were confirmed with representatives of the Ministries of Health and leaders from the countries at the second Latin American Stroke Ministerial Meeting.</jats:p><jats:p><jats:bold>Results:</jats:bold> In 2 years, public stroke awareness initiatives increased from 25 to 75% of countries. All countries have started programs to encourage physical activity, and there has been an increase in the number of countries that implement, at least partially, strategies to identify and treat hypertension, diabetes, and lifestyle risk factors. Programs to identify and treat dyslipidemia and atrial fibrillation still remained poor. The number of stroke centers increased from 322 to 448, all of them providing intravenous thrombolysis, with an increase in countries with stroke units. All countries have mechanical thrombectomy, but mostly restricted to a few private hospitals. Pre-hospital organization remains limited. The utilization of telemedicine has increased but is restricted to a few hospitals and is not widely available throughout the country. Patients have late, if any, access to rehabilitation after hospital discharge.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> The initiative to collaborate, exchange experiences, and unite societies and governments to improve stroke care in Latin America has yielded good results. Important advances have been made in the region in terms of increasing the number of acute stroke care services, implementing reperfusion treatments and creating programs for the detection and treatment of risk factors. We hope that this approach can reduce inequalities in stroke care in Latin America and serves as a model for other under-resourced environments.</jats:p>
Scopus© Citations 37 1
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COVID-19 Lockdown Effects on Acute Stroke Care in Latin America
(2021)
Virginia A. Pujol-Lereis
;
Alan Flores
;
Miguel A. Barboza
;
Carlos Abanto-Argomedo
;
Pablo Amaya
Scopus© Citations 12 4
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Priorities to reduce the burden of stroke in Latin American countries
(2019)
Sheila C Ouriques Martins
;
Claudio Sacks
;
Werner Hacke
;
Michael Brainin
;
Francisco de Assis Figueiredo
Scopus© Citations 107 7

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