@article{hbkup:/content/journals/10.5339/jemtac.2023.7, author = "Becker, Ryan and Fivelstad, Kat and Barnum, Mike and Hazan, Alberto and Olivieri, Patrick", title = "Delayed care for STEMI and embolic stroke patients", journal= "Journal of Emergency Medicine, Trauma and Acute Care", year = "2023", volume = "2023", number = "1", pages = "", doi = "https://doi.org/10.5339/jemtac.2023.7", url = "https://www.qscience.com/content/journals/10.5339/jemtac.2023.7", publisher = "Hamad bin Khalifa University Press (HBKU Press)", issn = "1999-7094", type = "Journal Article", keywords = "pandemic", keywords = "embolic stroke", keywords = "STEMI", keywords = "COVID-19", eid = "7", abstract = "Objective: The study sought to determine if the arrival of patients experiencing ST-segment elevation myocardial infarction (STEMI) or cerebrovascular accident to the emergency department (ED) was delayed due to fear of COVID-19, among other factors. Both these disease processes are time-dependent, and great efforts have been made to intervene in this pathology quickly to help improve patient-centered outcomes. Methods: A retrospective, case-control study was conducted using data from patient records from March to June 2019 and March to June 2020 from Spring Valley Hospital in Las Vegas, Nevada, USA. Chi-square analyses were performed to determine whether times to presentation for STEMIs and embolic strokes differed between 2019 and 2020 and between March and June using the times to present during the months following the U.S. COVID-19 emergency declaration on March 13th, 2020 (March, April, May, and June). The 432 STEMI and 183 stroke activations were reported during these months. Results: The results displayed an increase in presentation time for STEMI complaints (χ2 [3, N = 2289] = 109.8, p < 0.01) and for stroke complaints (χ2 [3, N = 1011] = 182.8, p < 0.01). The increase in times to presentation for STEMI and embolic stroke patients in the months following the emergency declaration compared to the year prior suggests that patients delayed presentation to the ED. Conclusion: During the pandemic, there was an increase in time to seek treatment for STEMI and embolic stroke patients from the onset of symptoms to their arrival at the ED. This was likely due to patients’ hesitancy to seek treatment due to fear of contracting COVID-19, scarce emergency medical services (EMS) resources, and the flux of new hospital-based virus screening. Data from stroke patients was more heterogenous, likely due to both patients and observers being able to activate the EMS system. These findings may support changes to future public health pandemic guidelines and health education.", }