Onset-to-Door Time of Stroke Patients in Stroke Fast Track between the Period of Before and After the Coronavirus Disease 2019 Pandemic Situation in a Community Hospital

Abstract

               Stroke is one of the major health problems in Thailand. The use of intravenous alteplase has
been the standard treatment for acute ischemic stroke FAST track; onset <4.5 hours, which Bangpakong
hospital defines the patient whose clinical suspected of stroke with onset time <3 hours as stroke
FAST track. During the COVID-19 situation, screening for COVID-19 infection has been done in all
patients before referred to Center Hospital. This study was to compare onset-to-door time and to find the
prevalence of acute stroke FAST track patients before and after the pandemic situation of COVID-19.
A cross-sectional study was performed by using secondary data of the stroke FAST track patient in the
emergency room of Bangpakong Hospital between October 2019, and September 2021. The general
demographic data were analyzed with descriptive statistics, nominal variables by number and percentage,
and was correlated with Chi-square test. The difference in onset-to-door time before and after the
COVID-19 situation was analyzed by Mann-Whitney U test. Statistical significance was recognized at
a p-value<0.05. The prevalence of stroke FAST track was higher after COVID-19 pandemic
which was 77 and 63 respectively. Onset-to-door time before and after COVID-19 were
93.7±60.44 minutes and 114.5±58.78 minutes respectively which statistical significantly
increase (p<0.05). Onset time were significantly difference, 64.05±43.80 minutes and
86.17±51.531 minutes respectively (p<0.05). Refer time were not different between two
groups, 29.65±29.37 minutes and 28.99±43.81 minutes respectively (p>0.05). Onsetto-
door time before and after COVID-19 were statistical significantly increase due to the
longer duration of onset time while the refer times were not different between the two
groups. The prevalence of acute stroke FAST track was higher after COVID-19 pandemic.