Social and clinical vulnerability in stroke and STEMI management during the COVID-19 pandemic: a registry-based study
| dc.rights.license | open | en_US |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | LESAINE, Emilie | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | FRANCIS, Florence | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | DOMECQ, Sandrine | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | MIGANEH HADI, Sahal | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | SEVIN, Floriane | |
| hal.structure.identifier | Institut de Neurosciences cognitives et intégratives d'Aquitaine [INCIA] | |
| dc.contributor.author | SIBON, Igor | |
| dc.contributor.author | ROUANET, Francois | |
| dc.contributor.author | PRADEAU, Catherine | |
| dc.contributor.author | COSTE, Pierre | |
| dc.contributor.author | CETRAN, Laura | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | VANDENTORREN, Stephanie | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | SAILLOUR, Florence | |
| dc.date.accessioned | 2024-05-06T12:31:04Z | |
| dc.date.available | 2024-05-06T12:31:04Z | |
| dc.date.issued | 2024-01-03 | |
| dc.identifier.issn | 2044-6055 | en_US |
| dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/199661 | |
| dc.description.abstractEn | OBJECTIVE: This study aims to evaluate whether the first wave of the COVID-19 pandemic resulted in a deterioration in the quality of care for socially and/or clinically vulnerable stroke and ST-segment elevation myocardial infarction (STEMI) patients. DESIGN: Two cohorts of STEMI and stroke patients in the Aquitaine neurocardiovascular registry. SETTING: Six emergency medical services, 30 emergency units, 14 hospitalisation units and 11 catheterisation laboratories in the Aquitaine region in France. PARTICIPANTS: This study involved 9218 patients (6436 stroke and 2782 STEMI patients) in the neurocardiovascular registry from January 2019 to August 2020. PRIMARY OUTCOME MEASURES: Care management times in both cohorts: first medical contact-to-procedure time for the STEMI cohort and emergency unit admission-to-imaging time for the stroke cohort. Associations between social (deprivation index) and clinical (age >65 years, neurocardiovascular history) vulnerabilities and care management times were analysed using multivariate linear mixed models, with an interaction on the time period (pre-wave, per-wave and post-first COVID-19 wave). RESULTS: The first medical contact procedure time was longer for elderly (p<0.001) and 'very socially disadvantaged' (p=0.003) STEMI patients, with no interaction regarding the COVID-19 period (age, p=0.54; neurocardiovascular history, p=0.70; deprivation, p=0.64). We found no significant association between vulnerabilities and the admission imaging time for stroke patients, and no interaction with respect to the COVID-19 period (age, p=0.81; neurocardiovascular history, p=0.34; deprivation, p=0.95). CONCLUSIONS: This study revealed pre-existing inequalities in care management times for vulnerable STEMI and stroke patients; however, these inequalities were neither accentuated nor reduced during the first COVID-19 wave. Measures implemented during the crisis did not alter the structured emergency pathway for these patients. TRIAL REGISTRATION NUMBER: NCT04979208. | |
| dc.language.iso | EN | en_US |
| dc.rights | Attribution-NonCommercial 3.0 United States | * |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc/3.0/us/ | * |
| dc.subject.en | COVID-19 | |
| dc.subject.en | Health Equity | |
| dc.subject.en | Health Services Accessibility | |
| dc.subject.en | Health policy | |
| dc.subject.en | Organisation of health services | |
| dc.subject.en | Quality in health care | |
| dc.title.en | Social and clinical vulnerability in stroke and STEMI management during the COVID-19 pandemic: a registry-based study | |
| dc.title.alternative | BMJ Open | en_US |
| dc.type | Article de revue | en_US |
| dc.identifier.doi | 10.1136/bmjopen-2023-073933 | en_US |
| dc.subject.hal | Sciences du Vivant [q-bio]/Santé publique et épidémiologie | en_US |
| dc.identifier.pubmed | 38171619 | en_US |
| bordeaux.journal | BMJ Open | en_US |
| bordeaux.page | e073933 | en_US |
| bordeaux.volume | 14 | en_US |
| bordeaux.hal.laboratories | Bordeaux Population Health Research Center (BPH) - UMR 1219 | en_US |
| bordeaux.issue | 1 | en_US |
| bordeaux.institution | Université de Bordeaux | en_US |
| bordeaux.institution | INSERM | en_US |
| bordeaux.institution | CNRS | |
| bordeaux.team | PHARES_BPH | en_US |
| bordeaux.peerReviewed | oui | en_US |
| bordeaux.inpress | non | en_US |
| bordeaux.identifier.funderID | Fondation de France | en_US |
| bordeaux.identifier.funderID | Conseil Régional Aquitaine | en_US |
| bordeaux.identifier.funderID | Assistance Publique - Hôpitaux de Paris | en_US |
| bordeaux.identifier.funderID | Institut Pasteur | en_US |
| hal.identifier | hal-04569594 | |
| hal.version | 1 | |
| hal.date.transferred | 2024-05-06T12:31:07Z | |
| hal.popular | non | en_US |
| hal.audience | Internationale | en_US |
| hal.export | true | |
| dc.rights.cc | Pas de Licence CC | en_US |
| bordeaux.COinS | ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=BMJ%20Open&rft.date=2024-01-03&rft.volume=14&rft.issue=1&rft.spage=e073933&rft.epage=e073933&rft.eissn=2044-6055&rft.issn=2044-6055&rft.au=LESAINE,%20Emilie&FRANCIS,%20Florence&DOMECQ,%20Sandrine&MIGANEH%20HADI,%20Sahal&SEVIN,%20Floriane&rft.genre=article |
