Nam Taek Min, Kim Do-Hyung, Jang Ji Hwan, Kim Young Zoon, Kim Kyu Hong, Kim Seung Hwan
Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
J Korean Neurosurg Soc. 2022 Mar;65(2):269-275. doi: 10.3340/jkns.2021.0076. Epub 2022 Feb 3.
The coronavirus disease 2019 (COVID-19) pandemic is affecting the characteristics of patients with head injuries. This study aimed to evaluate the effect of the COVID-19 pandemic on patients with head injuries at a regional emergency medical center in South Korea.
From April 2019 to November 2020, 350 patients with head injuries were admitted to our hospital. The study period was divided into the pre-COVID-19 (n=169) and COVID-19 (n=181) eras (10 months each). Patients with severe head injuries requiring surgery (n=74) were categorized into those who underwent surgery (n=41) and those who refused surgery (n=33).
Head injuries in pediatric patients (<3 years) were more frequent in the COVID-19 era than in the pre-COVID-19 era (8.8% vs. 3.6%, p=0.048). More patients refused surgery in the COVID-19 era than in the pre-COVID-19 era (57.9% vs. 30.6%, p=0.021). Refusal of surgery was associated with old age (67.7±14.5 vs. 52.4±19.1, p<0.001), marital status (married, 84.8% vs. 61.0%, p=0.037), unemployment (42.4% vs. 68.3%, p=0.034), COVID-19 era (66.7% vs. 39.0%, p=0.021), and lower Glasgow coma scale scores (6.12±3.08 vs. 10.6±3.80, p<0.001). Multivariable logistic regression analysis revealed that refusal of surgery was independently associated with old age (adjusted odds ratio [OR], 1.084; 95% confidence interval [CI], 1.030-1.140; p=0.002), COVID-19 era (adjusted OR, 6.869; 95% CI, 1.624-29.054; p=0.009), and lower Glasgow coma scale scores (adjusted OR, 0.694; 95% CI, 0.568-0.848; p<0.001).
We observed an increased prevalence of head injuries in pediatric patients (<3 years) during the COVID-19 pandemic. Additionally, among patients with severe head injuries requiring surgery, more patients refused to undergo surgery during the COVID-19 pandemic.
2019年冠状病毒病（COVID-19）大流行正在影响头部受伤患者的特征。本研究旨在评估COVID-19大流行对韩国一家地区急诊医疗中心头部受伤患者的影响。
2019年4月至2020年11月，350例头部受伤患者入住我院。研究期分为COVID-19前（n = 169）和COVID-19（n = 181）两个时期（各10个月）。需要手术的重度头部受伤患者（n = 74）分为接受手术的患者（n = 41）和拒绝手术的患者（n = 33）。
COVID-19时期儿科患者（<3岁）头部受伤的发生率高于COVID-19前时期（8.8%对3.6%，p = 0.048）。COVID-19时期拒绝手术的患者比COVID-19前时期更多（57.9%对30.6%，p = 0.021）。拒绝手术与老年（67.7±14.5对52.4±19.1，p<0.001）、婚姻状况（已婚，84.8%对61.0%，p = 0.037）、失业（42.4%对68.3%，p = 0.034）、COVID-19时期（66.7%对39.0%，p = 0.021）以及较低的格拉斯哥昏迷量表评分（6.12±3.08对10.6±3.80，p<0.001）有关。多变量逻辑回归分析显示，拒绝手术与老年（调整优势比[OR]，1.084；95%置信区间[CI]，1.030 - 1.140；p = 0.002）、COVID-19时期（调整OR，6.869；95% CI，1.624 - 29.054；p = 0.009）以及较低的格拉斯哥昏迷量表评分（调整OR，0.694；95% CI，0.568 - 0.848；p<0.001）独立相关。
我们观察到在COVID-19大流行期间，儿科患者（<3岁）头部受伤的患病率增加。此外，在需要手术的重度头部受伤患者中，COVID-19大流行期间更多患者拒绝接受手术。
