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诺曼底重症监护室严重创伤性脑损伤相关死亡人数减少:COVID-19 大流行至少带来一个积极影响。

Decreased number of deaths related to severe traumatic brain injury in intensive care unit during the first lockdown in Normandy: at least one positive side effect of the COVID-19 pandemic.

机构信息

Department of Neurosurgery, Caen University Hospital, Avenue de la Côte de Nacre, 14000, Caen, France.

Department of Neurosurgery, Rouen University Hospital, F-76000, Rouen, France.

出版信息

Acta Neurochir (Wien). 2021 Jul;163(7):1829-1836. doi: 10.1007/s00701-021-04831-1. Epub 2021 Apr 4.

Abstract

BACKGROUND

The COVID-19 pandemic has led to severe containment measures to protect the population in France. The first lockdown modified daily living and could have led to a decrease in the frequency of severe traumatic brain injury (TBI). In the present study, we compared the frequency and severity of severe TBI before and during the first containment in Normandy.

METHODS

We included all patients admitted in the intensive care unit (ICU) for severe TBI in the two tertiary neurosurgical trauma centres of Normandy during the first lockdown. The year before the containment served as control. The primary outcome was the number of patients admitted per week in ICU. We compared the demographic characteristics, TBI mechanisms, CT scan, surgical procedure, and mortality rate.

RESULTS

The incidence of admissions for severe TBI in Normandy decreased by 33% during the containment. The aetiology of TBI significantly changed during the containment: there were less traffic road accidents and more TBI related to alcohol consumption. Patients with severe TBI during the containment had a better prognosis according to the impact score (p=0.04). We observed a significant decrease in the rate of short-term mortality related to severe TBI during the period of lockdown (p=0.02).

CONCLUSIONS

Containment related to the COVID-19 pandemic has resulted in a modification of the mechanisms of severe TBI in Normandy, which was associated with a decline in the rate of short-term death in intensive unit care.

摘要

背景

COVID-19 大流行导致法国采取了严格的遏制措施来保护民众。第一次封锁改变了人们的日常生活,可能导致严重创伤性脑损伤(TBI)的发生频率降低。在本研究中,我们比较了诺曼底第一次封锁前后严重 TBI 的发生频率和严重程度。

方法

我们纳入了诺曼底两家三级神经外科创伤中心在 ICU 中因严重 TBI 而住院的所有患者。封锁前的一年作为对照。主要结局为 ICU 每周收治患者的人数。我们比较了人口统计学特征、TBI 机制、CT 扫描、手术程序和死亡率。

结果

在封锁期间,诺曼底收治严重 TBI 的患者人数减少了 33%。TBI 的病因在封锁期间发生了显著变化:道路交通事故减少,与酒精摄入相关的 TBI 增多。在封锁期间患有严重 TBI 的患者根据损伤评分(p=0.04)预后更好。我们观察到与 COVID-19 大流行相关的封锁期间严重 TBI 的短期死亡率显著下降(p=0.02)。

结论

与 COVID-19 大流行相关的封锁导致诺曼底严重 TBI 的机制发生改变,这与 ICU 中短期死亡的比率下降有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aed5/8019477/24d6bece2508/701_2021_4831_Fig1_HTML.jpg

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