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2019冠状病毒病大流行对急诊科创伤性脑损伤治疗效率的影响:台湾的一项多中心研究

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

作者信息

Lam Carlos, Yen Ju-Chuan, Wu Chia-Chieh, Lin Heng-Yu, Hsu Min-Huei

机构信息

Emergency Department, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan.

Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11030, Taiwan.

出版信息

J Clin Med. 2021 Nov 15;10(22):5314. doi: 10.3390/jcm10225314.

Abstract

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.

摘要

2019冠状病毒病(COVID-19)大流行对急诊科的业务产生了影响,其中包括创伤性脑损伤(TBI)的治疗,而TBI在急诊科较为常见。我们的研究旨在评估COVID-19大流行期间急诊科对TBI的治疗效率。利用台湾台北市三家医院的电子病历进行了一项回顾性观察研究。从急诊科就诊到脑部计算机断层扫描(CT)的时间以及从急诊科就诊到手术治疗的时间被用作治疗效率的衡量指标。将2020年(P1)当地小规模COVID-19疫情期间和2021年(P2)大规模社区传播期间急诊科对TBI的治疗效率与2019年记录的大流行前效率进行比较。与大流行前的间隔相比,P1和P2期间从急诊科就诊到脑部CT的间隔显著缩短,且未发现从急诊科就诊到手术治疗有显著延迟,这表明COVID-19大流行期间急诊科对TBI的治疗效率有所提高。尽量减少社区和医院内的病毒传播对于维持急诊科的治疗效率和能力至关重要。在COVID-19大流行期间,急诊科应保留足够的能力来治疗患有严重TBI的老年患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d04/8621260/3478753891df/jcm-10-05314-g001.jpg

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