Rupa Rosita, Vladimirov Tim, Pojskic Mirza, Nimsky Christopher, Voellger Benjamin
Department of Neurosurgery, University Hospital Marburg, Baldingerstrasse, 35033 Marburg, Germany.
Healthcare (Basel). 2022 Jul 24;10(8):1376. doi: 10.3390/healthcare10081376.
Objective: At the beginning of 2020, the COVID-19 pandemic enforced a rapid reallocation of healthcare resources. Our neurosurgical department is located in the German county of Marburg−Biedenkopf, about 80 km from the nearest major city. We were able to maintain our previously established open-door policy after the emergence of COVID-19. Here, we report on dynamics in the catchment area for neurotrauma patients at our department during the pandemic. Methods: 763 consecutive neurotrauma cases admitted to our department between 1 January 2018 and 31 December 2021 were analyzed retrospectively. Patients’ age, gender, origin, diagnoses, and outcomes were recorded. The number of patients hospitalized with a COVID-19 infection in Germany (PHCG) were retrieved from the Robert Koch Institute (RKI). We defined calendar weeks with >1000 PHCG as high COVID-19 caseload weeks (HCLW). Chi-square and Fisher’s exact served as statistical tests. Results: In 2020 and 2021, we observed a significantly increased number of neurotrauma patients who, with primary residence outside of our district, were admitted to our hospital compared to 2018 and 2019 (p < 0.001), while there were no significant differences in in-house mortality. During HCLW, a significantly increased number of neurotrauma patients with primary residence in the densely populated southwestern margin (SWM) of the contiguous part of our catchment area were referred to us compared to the time prior to the pandemic and between HCLW (p = 0.003). In neurotrauma patients admitted from the SWM during HCLW, there was no tendency towards higher in-house mortality. Conclusion: An open-door policy may moderate the risk of involuntarily triaging neurotrauma patients during a pandemic.
2020年初，新冠疫情迫使医疗资源迅速重新分配。我们的神经外科位于德国马尔堡-比登科普夫县，距离最近的大城市约80公里。新冠疫情出现后，我们得以维持先前制定的开放政策。在此，我们报告疫情期间我院神经创伤患者集水区的动态情况。方法：回顾性分析2018年1月1日至2021年12月31日期间我院收治的763例连续性神经创伤病例。记录患者的年龄、性别、籍贯、诊断和预后。德国新冠病毒感染住院患者（PHCG）数量从罗伯特·科赫研究所（RKI）获取。我们将PHCG>1000的日历周定义为新冠高病例负荷周（HCLW）。采用卡方检验和费舍尔精确检验作为统计方法。结果：与2018年和2019年相比，2020年和2021年我们观察到居住在我院所在地区以外的神经创伤患者入院人数显著增加（p<0.001），而院内死亡率无显著差异。在HCLW期间，与疫情前及HCLW之间相比，居住在我院集水区毗邻部分人口密集的西南边缘（SWM）的神经创伤患者转诊至我院的人数显著增加（p=0.003）。在HCLW期间从SWM收治的神经创伤患者中，没有院内死亡率升高的趋势。结论：开放政策可能会降低疫情期间神经创伤患者非自愿分流的风险。
