Pre-hospital emergency care for patients with suspected stroke during the COVID-19 pandemic: a retrospective analysis from the Ústí nad Labem Region

Abstract

Purpose is to evaluate the impact of the first year of the COVID-19 pandemic on selected temporal and organizational parameters of prehospital emergency care for patients with suspected stroke in the Ústí nad Labem Region by comparing system performance before and during the pandemic. Materials and Methods. A retrospective observational study was conducted using data from the Electronic Patient Record system of the Ústí nad Labem Region Emergency Medical Service. Patients with suspected stroke (ICD-10 codes I60–I64) treated between March 2019 and February 2021 were included. Two 12-month periods were compared: pre-pandemic (March 2019–February 2020) and pandemic (March 2020–February 2021). Primary outcomes were dispatch call-processing time, response time, and on-scene time. Statistical analyses were performed in R (version 4.5.1) using the Wilcoxon rank-sum test, chi-square test, and two-proportion test (α = 0.05). Results. A total of 1.783 emergency calls were analysed (917 pre-pandemic, 866 pandemic). No significant differences were found in the number of patients (p = 0.488), median age (73 years; p = 0.785), or distribution of calls by time of day (p = 0.598). During the pandemic, median response time increased from 11:03 to 11:57 (p < 0.001), while dispatch call-processing time increased from 2:44 to 2:58 (p < 0.001). On-scene time remained unchanged at 22:00 minutes (p = 0.362). Conclusions. The prehospital emergency care system remained resilient during the COVID-19 pandemic. Although dispatch and response times increased slightly, stable on-scene times indicate effective adaptation of emergency medical teams. Dispatch centres appear to be the most vulnerable component of the prehospital stroke care pathway and should be prioritised in future emergency preparedness planning.