How has the COVID‒19 pandemic affected the prehospital transport of thrombectomy cases?

Abstract

  We investigated the impact of the COVID‒19 pandemic on the transport of thrombectomy cases transported to our facility in Tokyo. The patients’ demographics, the transport time and distance, the ratio of transportation from another secondary healthcare area, and clinical outcomes were compared between before and after the declaration of Japan’s state of COVID‒19 emergency (the pandemic era was defined as the post‒declaration era). We examined the cases of 123 patients (pre‒pandemic era, n=91; pandemic era, n=32). In the pre‒pandemic and pandemic eras, the median time from the patients’ ambulance calls to departure were 25 min and 26.5 min (p=0.43), the median times from departure to our facility (door) were 11 min and 12 min (p=0.20) the median transport distances were 3.1 km and 3.6 km (p=0.38), the ratios of transportation from another area were 8.8% and 28.1% (p=0.01), and the median modified Rankin Scale values at 90 days were 3:3 (p=0.36), respectively. Although the number of patients transported to our facility from another area increased in the pandemic era, the increase did not lead to a delay in transport time or to any deterioration in patient outcomes; we attribute this to the densely located primary stroke centers and the acute stroke transport system in Tokyo.