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COVID-19 对三级神经外科中心神经外科颅脑外伤转介和入院的影响。

The impact of COVID-19 on neurosurgical head trauma referrals and admission at a tertiary neurosurgical centre.

机构信息

University of Manchester, Manchester, UK.

Department of Neurosurgery, Salford Royal NHS Foundation Trust, Salford, UK.

出版信息

J Clin Neurosci. 2021 May;87:50-54. doi: 10.1016/j.jocn.2021.02.021. Epub 2021 Mar 2.

Abstract

BACKGROUND

COVID-19 has greatly impacted surgical specialities throughout the globe leading to a decrease in hospital admissions and referrals. Neurosurgery has seen a great decline in cases including head trauma leading to a negative impact on the development of neurosurgical trainees. The main objective of this study is to the identify changes in neurosurgical referrals, admissions and management during the COVID-19 pandemic. We also aim to assess how current practise could be adapted to help manage future pandemic peaks.

METHODS

Data was collected for the first 31 days of lockdown during 2020 (23rd March - 22nd April) and compared to the same time period in the years 2016-2019. We assessed the number of referrals, admissions and clinical information of patients during this period with a key emphasis on head trauma.

RESULTS

Neurosurgical head injury referrals and admissions reduced by 57.5% and 48.3% respectively during the first 31 days of lockdown when compared to the mean figures for the same period in the previous 4 years. This was also seen with head trauma with a 21.9% decline in referrals and 39.1% reduction in admissions for the period of interest. A significant decrease in length of stay (P < 0.001) was seen between 2020 and the years 2017-19.

CONCLUSION

The impact of COVID-19 makes it imperative that we plan for future pandemics to lessen the impact on neurosurgery. Special considerations need to be taken so that trainees are sufficiently prepared for completion of training whilst still priotising patient safety and providing high quality care.

摘要

背景

COVID-19 对全球外科专业造成了巨大影响,导致医院入院率和转诊率下降。神经外科的病例数量大幅下降,包括头部创伤,这对神经外科受训者的发展产生了负面影响。本研究的主要目的是确定 COVID-19 大流行期间神经外科转诊、入院和管理的变化。我们还旨在评估如何调整当前的实践,以帮助管理未来的大流行高峰。

方法

收集了 2020 年封锁的头 31 天(3 月 23 日至 4 月 22 日)的数据,并与 2016-2019 年同期的数据进行了比较。在此期间,我们评估了患者的转诊、入院和临床信息数量,重点是头部创伤。

结果

与前 4 年同期的平均值相比,封锁的头 31 天内,神经外科头部损伤的转诊和入院分别减少了 57.5%和 48.3%。在同期,头部创伤的转诊减少了 21.9%,入院减少了 39.1%。与 2017-19 年相比,2020 年的住院时间明显缩短(P<0.001)。

结论

COVID-19 的影响使得我们必须为未来的大流行做好规划,以减轻对神经外科的影响。需要特别考虑,以便受训者在完成培训的同时充分准备,同时仍然优先考虑患者安全并提供高质量的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/847a/7923951/4e97f5aa23ec/gr1_lrg.jpg

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