Impact of Coronavirus Disease 2019 Shutdown on Neurotrauma Volume in Pennsylvania

Algattas, Hanna; McCarthy, David; Kujawski, Brandon; Agarwal, Nitin; Brown, Joshua B.; Forsythe, Raquel M.; Leonardo, Jody; Walsh, Kevin M.; Gross, Bradley A.; Friedlander, Robert M.; Okonkwo, David O.; Whiting, Donald; Miele, Vincent

doi:10.1016/j.wneu.2021.04.004

Cited by 8 publications

(14 citation statements)

References 24 publications

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“…Evidence of significant sex differences is limited, and there is a conflicting picture ( 10 , 25 , 26 ), probably due to regional variation. The study by Algattas et al ( 6 ) found no differences in the mean and median age of neurotrauma patients, but significant differences in age distribution. This highlights the need for an accurate analysis of the age distribution of TBI.…”

Section: Discussionmentioning

confidence: 89%

“…Comparing TBI referrals during lockdown with previous years, many studies showed a decrease in the incidence of referrals and admissions during lockdown periods ( 1 – 6 ). However, the relief of lockdown measures was accompanied by increases in TBIs ( 2 , 7 ).…”

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confidence: 99%

“…The observed changes may be explained by lockdown measures resulting in people staying at home, which led to global reductions in road traffic accidents (RTAs) ( 1 , 8 – 10 ). Neurotrauma was more likely to take place indoors at private residences, accompanied by increases in falls, which were seen among > 65-year-olds ( 6 ). Regarding management of TBI, Manivannan et al ( 9 ) found a significant decrease in surgical management of TBI, with a comparable increase in conservative management.…”

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confidence: 99%

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Referrals to Early Specialized Rehabilitation after Traumatic Brain Injury during the Covid-19 Pandemic

Tverdal

Brunborg

Helseth

et al. 2022

JRM

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Objective: To quantify potential changes in direct referral to early specialized rehabilitation during the COVID-19 pandemic and the injury pattern of patients hospitalized with traumatic brain injury (TBI) at a level 1 trauma centre.Methods: In this registry-based study, data were retrieved from the Oslo TBI Registry-Neurosurgery and included adult patients with injury-related intracranial findings admitted to Oslo University Hospital (OUH). The study focused on a period of time when OUH was in any level of preparedness because of the COVID-19 pandemic; March 2020 to August 2021. For comparison, the study used patients hospitalized for TBI in 2018 and 2019.Results: A total of 1,310 hospitalized patients with TBI were divided into 2 groups; pre-pandemic and pandemic. Direct referral to early rehabilitation was maintained. Patient volume remained stable, and there were no differences between the groups regarding patient characteristics and acute management, although there was a significantly higher proportion of TBIs secondary to electric scooter accidents in the pandemic group. Results from univariable and multivariable logistic regression showed a multifaceted reality, but younger age, none or mild preinjury comorbidity and severe disability due to TBI at discharge from acute care remained stable strong predictors of direct referral to rehabilitation.Conclusion: For patients with moderate-severe TBI, the direct pathway to early specialized rehabilitation was maintained during 2020–21. However, the pandemic continued and the long-term impact for rehabilitation services is not yet known.

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Section: Discussionmentioning

confidence: 89%

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confidence: 99%

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confidence: 99%

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Referrals to Early Specialized Rehabilitation after Traumatic Brain Injury during the Covid-19 Pandemic

Tverdal

Brunborg

Helseth

et al. 2022

JRM

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“…When facing the anticipated first surge, many ICUs shifted priorities to accommodate COVID-19 patients,38 balancing the care of critically ill COVID-19 and non-COVID-19 patients 39. There are conflicting data on disease severity and mortality in the pandemic period compared with prepandemic trends 40–43. Early in the pandemic, critical care capacity for NCC patients was preserved by a temporary suspension of elective non-neurological and neurological surgeries, including elective endovascular, cranioplasty, and open cerebrovascular procedures 44,45.…”

Section: Discussionmentioning

confidence: 99%

“…39 There are conflicting data on disease severity and mortality in the pandemic period compared with prepandemic trends. [40][41][42][43] Early in the pandemic, critical care capacity for NCC patients was preserved by a temporary suspension of elective non-neurological and neurological surgeries, including elective endovascular, cranioplasty, and open cerebrovascular procedures. 44,45 Strategies to generate additional staffing for ICU teams included: (a) reallocation or redeployment of existing ICU clinicians by specialty and subspecialty training; (b) utilization of non-ICU based clinicians, such as registered certified nurse anesthetists, to participate in routine critical care delivery; (c) return to work of retired physicians and nurses, 9 and; (d) recruitment of traveler nurses or per diem personnel.…”

Section: Impact Of the Covid-19 Pandemic On Neurocritical Care Delive...mentioning

confidence: 99%

Perceptions Regarding the SARS-CoV-2 Pandemic’s Impact on Neurocritical Care Delivery: Results From a Global Survey

Lele

Wahlster²,

Alunpipachathai³

et al. 2021

Journal of Neurosurgical Anesthesiology

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Background: The SARS-CoV-2 (COVID-19) pandemic has impacted many facets of critical care delivery. Methods: An electronic survey was distributed to explore the pandemic’s perceived impact on neurocritical care delivery between June 2020 and March 2021. Variables were stratified by World Bank country income level, presence of a dedicated neurocritical care unit (NCCU) and experiencing a COVID-19 patient surge. Results: Respondents from 253 hospitals (78.3% response rate) from 47 countries (45.5% low/middle income countries; 54.5% with a dedicated NCCU; 78.6% experienced a first surge) participated in the study. Independent of country income level, NCCU and surge status, participants reported reductions in NCCU admissions (67%), critical care drug shortages (69%), reduction in ancillary services (43%) and routine diagnostic testing (61%), and temporary cancellation of didactic teaching (44%) and clinical/basic science research (70%). Respondents from low/middle income countries were more likely to report lack of surge preparedness (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.8-5.8) and struggling to return to prepandemic standards of care (OR, 12.2; 95% CI, 4.4-34) compared with respondents from high-income countries. Respondents experiencing a surge were more likely to report conversion of NCCUs and general-mixed intensive care units (ICUs) to a COVID-ICU (OR 3.7; 95% CI, 1.9-7.3), conversion of non-ICU beds to ICU beds (OR, 3.4; 95% CI, 1.8-6.5), and deviations in critical care and pharmaceutical practices (OR, 4.2; 95% CI 2.1-8.2). Respondents from hospitals with a dedicated NCCU were less likely to report conversion to a COVID-ICU (OR, 0.5; 95% CI, 0.3-0.9) or conversion of non-ICU to ICU beds (OR, 0.5; 95% CI, 0.3-0.9). Conclusion: This study reports the perceived impact of the COVID-19 pandemic on global neurocritical care delivery, and highlights shortcomings of health care infrastructures and the importance of pandemic preparedness.

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Critical Care

Grantham

Karev

Karpinos

et al. 2022

Health Crisis Management in Acute Care Hospitals

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Impact of Coronavirus Disease 2019 Shutdown on Neurotrauma Volume in Pennsylvania

Cited by 8 publications

References 24 publications

Referrals to Early Specialized Rehabilitation after Traumatic Brain Injury during the Covid-19 Pandemic

Referrals to Early Specialized Rehabilitation after Traumatic Brain Injury during the Covid-19 Pandemic

Perceptions Regarding the SARS-CoV-2 Pandemic’s Impact on Neurocritical Care Delivery: Results From a Global Survey

Critical Care

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