Department of Neurological Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Department of Neurological Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
World Neurosurg. 2020 Nov;143:e344-e350. doi: 10.1016/j.wneu.2020.07.155. Epub 2020 Jul 27.
New York City is the epicenter of the novel coronavirus disease 2019 (COVID-19) pandemic in the United States. Traumatic brain injury accounts for a significant proportion of admissions to our trauma center. We sought to characterize the effect of the pandemic on neurotraumas, given the cancellation of nonessential activities during the crisis.
Retrospective and prospective reviews were performed from November 2019 to April 2020. General demographics, clinical status, mechanism of trauma, diagnosis, and treatment instituted were recorded. We dichotomized the data between pre-COVID-19 (before 1 March) and COVID-19 periods and compared the differences between the 2 groups. We present the timeline of events since the beginning of the crisis in relation to the number of neurotraumas.
A total of 150 patients composed our cohort with a mean age of 66.2 years (standard deviation ±18.9), and 66% were male. More males sustained neurotrauma in the COVID-19 period compared with the pre-COVID-19 (60.4% vs. 77.6%, P = 0.03). The most common mechanism of trauma was mechanical fall, but it was observed less frequently compared with the pre-COVID-19 period (61.4% vs. 40.8; P = 0.03). Subdural hematoma, traumatic subarachnoid hemorrhage, and intracerebral contusion accounted for the most common pathologies in both periods. Nonoperative management was selected for most patients (79.2 vs. 87.8%, P = 0.201) in both periods.
A decrease in the frequency of neurotraumas was observed during the COVID-19 crisis concomitant with the increase in COVID-19 patients in the city. This trend began after the cancellation of nonessential activities and implementation of social distancing recommendations.
纽约市是美国 2019 年新型冠状病毒病(COVID-19)大流行的中心。创伤性脑损伤在我们的创伤中心的入院人数中占很大比例。鉴于在危机期间取消了非必要活动,我们试图描述大流行对神经创伤的影响。
从 2019 年 11 月至 2020 年 4 月进行了回顾性和前瞻性研究。记录了一般人口统计学,临床状况,创伤机制,诊断和所实施的治疗。我们将数据分为 COVID-19 之前(3 月 1 日之前)和 COVID-19 期间,并比较了两组之间的差异。我们展示了自危机开始以来与神经创伤数量有关的事件时间表。
共有 150 名患者组成了我们的队列,平均年龄为 66.2 岁(标准差±18.9),66%为男性。与 COVID-19 之前相比,更多的男性在 COVID-19 期间遭受了神经创伤(60.4%对 77.6%,P = 0.03)。最常见的创伤机制是机械性跌倒,但与 COVID-19 之前相比,这种情况发生的频率较低(61.4%对 40.8%,P = 0.03)。在两个时期,硬膜下血肿,创伤性蛛网膜下腔出血和脑挫裂伤占最常见的病理类型。在两个时期,大多数患者都选择了非手术治疗(79.2%对 87.8%,P = 0.201)。
随着该市 COVID-19 患者的增加,在 COVID-19 危机期间,神经创伤的频率有所下降。这种趋势始于取消非必要活动和实施社会隔离建议之后。