The impact of COVID-19 on trauma referrals to a National Neurosurgical Centre

Horan, Jack; Duddy, John; Gilmartin, Brian; Amoo, Michael; Nolan, Deirdre; Corr, Paula; Husien, Mohammed Ben; Bolger, Ciarán

doi:10.1007/s11845-021-02504-7

Cited by 32 publications

(29 citation statements)

References 23 publications

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“…COVID has had varying impacts on neurosurgical and neurotrauma patients worldwide. Emergent and non-emergent neurosurgical referrals and admissions have declined [ 10 , 11 , 16 , 17 ]. In contrast, TBI admission numbers to ICU have remained steady [ 11 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…These restrictions were relaxed on 18 May 2020, with some sectors returning to work and the gradual opening of schools and non-essential businesses [ 9 ]. Our group has previously shown that referrals to the national neurosurgical centre were reduced during the lockdown period of March–May 2020 [ 10 ]. Other studies showed that trauma and emergency presentations decreased by up to 50% across neurosurgery, other surgical specialities, and emergency departments as a result of lockdowns imposed by governments [ 11 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Neurotrauma admissions and COVID-19: a National Centre experience

et al. 2021

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Background To investigate the impact of COVID-19 on trauma admissions to a National Neurosurgical Centre in Ireland. Methods Retrospective analysis of a prospectively maintained database of all trauma admissions to the National Neurosurgical Centre at Beaumont Hospital, Dublin, during the period March 1 to May 31, 2019 and 2020. Primary outcome was 30-day mortality rate. Secondary outcomes included time transfer time, time from admission to time of surgery, and intensive care unit (ICU) admissions. Patients under the age of 16 were excluded. Results A total of 32 and 39 patients were admitted to the National Neurosurgical Centre following trauma over the 3-month period in 2020 and 2019 respectively, giving a 17.9% reduction in admissions. The 30-day mortality rate increased from 7.7% in 2019 to 15.6% on 2020 ( p = 0.45). Mean transfer time was 4 h 58 min in 2019 and 3 h 55 min in 2020 (0.22). Mean time from admission to time of surgery was 9 h 10 min in 2019 and 5 h 37 min in 2020 respectively ( p = 0.35). In 2019, 20 patients (51.3%) were admitted to ICU. This increased to 23 patients (69.7%) in 2020 ( p = 0.08). Conclusions Traumatic brain injury 30-day mortality rates increased during the first COVID-19 lockdown period. Trauma admission rates to ICU remained unchanged despite an overall reduction in trauma admissions. Transfer time, time to surgery, and length of stay were impacted by COVID-19. Despite the challenges COVID-19 has posed, it is important to maintain a fully functioning neurosurgical and neurocritical care service during the pandemic.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neurotrauma admissions and COVID-19: a National Centre experience

et al. 2021

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“…Since the emergence of the first COVID-19 case in Wuhan, the virus affected health care systems [1] . Globally, the COVID-19 has a performative effect on health care provision [2] . Substantial evidence was clear that the global surgical services were impacted [3] .…”

Section: Introductionmentioning

confidence: 99%

Analyzing outcomes of neurosurgical operations performed before and during the COVID-19 pandemic in Egypt. A matched single-center cohort study

Azab

Azzam

Eraky

et al. 2021

Interdisciplinary Neurosurgery

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Background Since the emergence of the first COVID-19 case in Wuhan, the virus affected several health care systems. Globally, the COVID-19 has a transforming effect on health care provision. Substantial evidence was clear that the global surgical services were impacted. The field of neurosurgery was primarily affected, and most elective surgeries were suspended. There are no current reports from Egypt that describe the mortality outcome of neurosurgical procedures in the context of the pandemic. Methods We performed that study at a large tertiary center in Egypt (Cairo University Hospital). It is a single-center matched cohort study. Results Our results examined about 346 patients earlier during the COVID-19 pandemic. About 46 (13.29%) were unmatched, so we excluded them from the final analysis of the data. About 300 patients' were matched to 304 patients' before the pandemic in 2019. The mortality outcome of neurosurgical interventions was higher during the pandemic. Conclusions Amid the COVID-19 pandemic, the mortality outcome of neurosurgical procedures was higher than on regular days at our center. The anesthesia time was prolonged while the operation time was shortened. We strongly suggest further multicenter studies to assess the effect of COVID-19 on neurosurgical mortality and functional outcome.

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“…Although the number of TBI cases has steadily increased over time [18,19], the number of TBI cases in the ED declined significantly during the COVID-19 pandemic, which is known as the "coronavirus lockdown effect" [20]. A study in the United Kingdom showed that referrals for TBI decreased by 49.6% [21], and the decreases reported in India, the Netherlands, and Ireland were 60%, 36%, and 17.1%, respectively [20,22,23]. For TBI patients, a brain computed tomography (CT) scan is indispensable to detect the presence of brain hemorrhage.…”

Section: Introductionmentioning

confidence: 99%

Effects of the COVID-19 Pandemic on Treatment Efficiency for Traumatic Brain Injury in the Emergency Department: A Multicenter Study in Taiwan

Lam

Yen

et al. 2021

JCM

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The coronavirus disease 2019 (COVID-19) pandemic has impacted emergency department (ED) practice, including the treatment of traumatic brain injury (TBI), which is commonly encountered in the ED. Our study aimed to evaluate TBI treatment efficiency in the ED during the COVID-19 pandemic. A retrospective observational study was conducted using the electronic medical records from three hospitals in metropolitan Taipei, Taiwan. The time from ED arrival to brain computed tomography (CT) and the time from ED arrival to surgical management were used as measures of treatment efficiency. TBI treatment efficiencies in the ED coinciding with a small-scale local COVID-19 outbreak in 2020 (P1) and large-scale community spread in 2021 (P2) were compared against the pre-pandemic efficiency recorded in 2019. The interval between ED arrival and brain CT was significantly shortened during P1 and P2 compared with the pre-pandemic interval, and no significant delay between ED arrival and surgical management was found, indicating increased treatment efficiency for TBI in the ED during the COVID-19 pandemic. Minimizing viral spread in the community and the hospital is vital to maintaining ED treatment efficiency and capacity. The ED should retain sufficient capacity to treat older patients with serious TBI during the COVID-19 pandemic.

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The impact of COVID-19 on trauma referrals to a National Neurosurgical Centre

Cited by 32 publications

References 23 publications

Neurotrauma admissions and COVID-19: a National Centre experience

Neurotrauma admissions and COVID-19: a National Centre experience

Analyzing outcomes of neurosurgical operations performed before and during the COVID-19 pandemic in Egypt. A matched single-center cohort study

Effects of the COVID-19 Pandemic on Treatment Efficiency for Traumatic Brain Injury in the Emergency Department: A Multicenter Study in Taiwan

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