Neurotrauma Emergencies during the SARS-CoV2 Pandemic at a Tertiary Medical Center: Analysis of Incidence and Outcome

Abstract

Background: We assess the impact of lockdown in Germany due to the COVID-19 pandemic on the incidence and outcome of neurotrauma emergencies at a tertiary medical center.

Methods: All neurosurgical emergencies from March 16, 2020 (first lockdown in Germany) to January 31, 2021 were included and compared with a longitudinal case-cohort. Cases were descriptively recorded and retrospectively analyzed with respect to incidence and outcome.

Results: All emergencies defined as polytrauma referred to our center decreased by 10% during the pandemic (n = 226), whereas neurosurgical emergencies increased by 18.4% (764 vs. 905 cases). The number of specific neurotrauma emergencies increased by 44.4% (63 vs. 91 cases), yet statistically not significant (p = 0.245). The duration of treatment in the intensive care unit (ICU) extended from 621 to 1,056 days (p = 0.34).

Conclusion: The reasons for the increase in the number of neurotrauma emergencies were the following: (1) many surrounding smaller care providers were canceled during this time and (2) there was a lack of free intensive care capacities in other hospitals, urging primarily maximum care providers to deal with more referrals. Both these facts and the prolonged treatment on ICUs strengthen the necessity for maximum care providers to keep ICU capacities for non-COVID patients. Specialized neurosurgical expertise should maintain in tertiary medical centers, even or particularly in exceptional circumstances such as the current pandemic.