Department of Neurosurgery, University Hospital Regensburg, Regensburg, Germany.
J Neurol Surg A Cent Eur Neurosurg. 2022 Jul;83(4):314-320. doi: 10.1055/s-0041-1739225. Epub 2021 Dec 12.
The coronavirus pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is posing unprecedented challenges to health care systems around the globe. Consequently, various lockdown scenarios have been politically imposed to get control over the spread of this disease. We examined the impact of the lockdown situation on the number of neurosurgical emergency patients admitted to our tertiary care center with a catchment area of ∼2.2 million inhabitants in the south of Germany to ensure adequate neurosurgical emergency care during a pandemic lockdown.
All emergency admissions (with consecutive inpatient treatment) to the Department of Neurosurgery at the University Medical Center Regensburg, Germany, between March 1 and May 8 (69 days) of the years 2018, 2019, and 2020 were retrospectively identified and reviewed for this study. Demographic data, diagnoses, urgency of surgery, and duration of the journey to the emergency room were examined.
Between March 1 and May 8, 2020, 59 emergency patients were neurosurgically treated at our department. Compared with 2018 and 2019, emergency admissions in 2020 had thus declined by 37.2 and 27.1%, respectively. Regarding the year 2020, we found a significant drop from 1.71 and 1.52 emergency patients per day in January and February 2020, respectively, to 0.86 during lockdown ( < 0.001). The decline especially concerned nontraumatic spinal cases and also patients with other neurosurgical diagnoses such as intracranial hemorrhage. Evaluation of the overall disease severity of admitted patients by means of the urgency of surgery showed no difference between the baseline years and the lockdown period.
Our findings are in line with other observational studies of neurosurgical, neurologic, and cardiologic centers in Europe that have described a drop in emergency cases. The reasons for this drop that seems to affect various medical fields and countries across Europe are still unidentified. Morbidity and mortality rates are still unknown, and efforts should be made to facilitate neurosurgical emergency care during a pandemic lockdown.
由严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）引起的冠状病毒大流行，正对全球各地的医疗体系构成前所未有的挑战。因此，为了控制这种疾病的传播，各国已采取了各种封锁措施。我们研究了封锁措施对我们三级护理中心（位于德国南部，服务人口约 220 万）收治的神经外科急诊患者数量的影响，以确保在大流行封锁期间提供充足的神经外科急诊护理。
回顾性分析 2018 年、2019 年和 2020 年 3 月 1 日至 5 月 8 日（69 天）期间，德国雷根斯堡大学医学中心神经外科收治的所有急诊入院（连续住院治疗）患者的资料，并进行了此项研究。研究检查了人口统计学数据、诊断、手术紧迫性和到急诊室的旅程时间。
2020 年 3 月 1 日至 5 月 8 日期间，我院神经外科共收治 59 例急诊患者。与 2018 年和 2019 年相比，2020 年的急诊入院人数分别下降了 37.2%和 27.1%。关于 2020 年，我们发现 1 月和 2 月的封锁前分别有 1.71 和 1.52 例急诊患者，而封锁期间降至 0.86 例（<0.001）。下降尤其涉及非创伤性脊柱病例，以及其他神经外科诊断（如颅内出血）的患者。通过手术紧迫性评估入院患者的整体疾病严重程度，发现基准年份和封锁期间无差异。
我们的研究结果与欧洲其他神经外科、神经科和心脏病中心的观察性研究一致，这些研究都描述了急诊病例数量的下降。导致这种下降的原因似乎影响了欧洲各地的各种医疗领域，但其原因仍不清楚。发病率和死亡率仍未知，应努力在大流行封锁期间为神经外科急诊护理提供便利。
