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To Alicia Arjona Paredes for her tireless support for research and projects to improve care for patients with acute stroke.

Analysis of institutional authors

Iglesias-Vazquez, Jose AntonioAuthor

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October 27, 2023
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Effect of the COVID-19 pandemic on advanced life support units' prehospital management of the stroke code in four Spanish regions: an observational study

Publicated to:Bmc Emergency Medicine. 23 (1): 116- - 2023-10-04 23(1), DOI: 10.1186/s12873-023-00886-8

Authors: Riera-López, N; Aranda-Aguilar, F; Gorchs-Molist, M; Iglesias-Vázquez, JA

Affiliations

Ctr Emergencias Sanit 061 CES 061, Cordoba Prov Serv, Cordoba, Spain - Author
Fdn Publ Urxencias Sanit Galicia 061 FPUSG 061, Santiago De Compostela, Spain - Author
Serv Urgencias Med Madrid SUMMA 112, Madrid, Spain - Author
Sistema Emergencies Med SEM, Barcelona, Spain - Author

Abstract

IntroductionStroke is the most common time-dependent pathology that pre-hospital emergency medical services (EMS) are confronted with. Prioritisation of ambulance dispatch, initial actions and early pre-notification have a major impact on mortality and disability. The COVID-19 pandemic has led to disruptions in the operation of EMS due to the implementation of self-protection measures and increased demand for care. It is crucial to evaluate what has happened to draw the necessary conclusions and propose changes to improve the system's strength for the future. The study aims to compare prehospital time and neuroprotective care metrics for acute stroke patients during the first wave of COVID-19 and the same periods in the years before and after.MethodsAnalytical, observational, multicentre study conducted in the autonomous communities of Andalusia, Catalonia, Galicia, and Madrid in the pre-COVID-19 (2019), "first wave" of COVID-19 (2020) and post-COVID-19 (2021) periods. Consecutive non-randomized sampling. Descriptive statistical analysis and hypothesis testing to compare the three time periods, with two by two post-hoc comparisons, and multivariate analysis.ResultsA total of 1,709 patients were analysed. During 2020 there was a significant increase in attendance time of 1.8 min compared to 2019, which was not recovered in 2021. The time of symptom onset was recorded in 82.8% of cases, and 83.3% of patients were referred to specialized stroke centres. Neuroprotective measures (airway, blood glucose, temperature, and blood pressure) were performed in 43.6% of patients.ConclusionDuring the first wave of COVID-19, the on-scene times of pre-hospital emergency teams increased while keeping the same levels of neuroprotection measures as in the previous and subsequent years. It shows the resilience of EMS under challenging circumstances such as those experienced during the pandemic.

Keywords

Acute ischemic-strokeCareCovid-19Emergency medical serviceEmergency medicineGuidelinesImpactNeuroprotectivePlanStrokeStroke codeTherapyTime

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Bmc Emergency Medicine due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2023, it was in position 13/54, thus managing to position itself as a Q1 (Primer Cuartil), in the category Emergency Medicine.

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-05:

  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 23 (PlumX).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.

Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: Last Author (Iglesias Dorado, Mª Victoria).