J Korean Neurosurg Soc.  2022 Jan;65(1):130-137. 10.3340/jkns.2021.0056.

Comparative Analysis of COVID-19 Outbreak and Changes in Neurosurgical Emergency Patients

• Lee MH
• Jang SR
• Lee TK

• KMID: 2523921
• DOI: http://doi.org/10.3340/jkns.2021.0056

Abstract

Objective
: COVID-19 has spread worldwide since the first case was reported in Wuhan, China, in December 2019. Our institution is a regional trauma and emergency center in the northern Gyeonggi Province. The changing trend of patient care in the emergency room of this hospital likely reflects the overall trend of patients in the area. In the present study, whether changes in the surrounding social environment following the outbreak of COVID-19 changed the incidence of neurosurgical emergency patients and whether differences in practice existed were investigated.
Methods
: The overall trend was analyzed from January 2020 which is before the outbreak of COVID-19 to September 2020. To remove bias due to seasonal variation, the previous 2 year's records during the same period were reviewed and compared. Confirmed COVID-19 patients in the northern Gyeonggi Province were identified using data released by the government. And patients who came to the emergency department with head trauma and stroke were identified.
Results
: Based on the present study results, the total number of neurosurgery emergency patients decreased over the study period. In the trauma patient group, the number of patients not involved in traffic accidents significantly decreased compared with patients involved in traffic accidents. Among the stroke cases, the rate of ischemic stroke was lower than hemorrhagic stroke, although a statistically significant difference was not observed. Meanwhile, an increase in the risk of mortality associated with trauma or stroke cases was not observed during the COVID-19 outbreak compared with the same time period in the previous year.
Conclusion
: Due to the occurrence of COVID-19, non-essential activities have decreased and trauma cases not associated with traffic accidents appeared to decrease. Due to the decrease in overall activity, the number of stroke patients has also decreased. This trend is expected to continue even in the post-COVID-19 era, and accordingly, the results from the present study are relevant especially if the current situation continues.

Keyword

COVID-19; Neurosurgery; Emergencies; Traumatic brain injury; Stroke

Figure

• 

  Fig. 1. Association between COVID-19 outbreak and head trauma patients. A : Weekly number of COVID-19 patients in northern Gyeonggi Province. B : Weekly number of head trauma patients compared between 2019 and 2020. C : Comparison of weekly increase or decrease in head trauma patients between 2019 and 2020. D : Comparison of weekly increase or decrease of major and mortality cases in head trauma patients between 2019 and 2020. E : Comparison of weekly increase or decrease in traffic accident-related cases and non-traffic accident-related cases in head trauma patients between 2019 and 2020. There was no noteworthy difference between the traumatic case of 2018 and 2019, the comparison of the increase and decrease bar graph was illustrated between 2019 and 2020 only.

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  Fig. 2. Association between COVID-19 outbreak and stroke patients. A : Weekly number of COVID-19 patients in northern Gyeonggi Province. B : Weekly comparison of the number of stroke patients between 2019 and 2020. C : Comparison of weekly increase or decrease in stroke patients between 2019 and 2020. D : Comparison of weekly increase or decrease in major and mortality cases of stroke patients between 2019 and 2020. E : Weekly comparison of increase or decrease of ischemic and hemorrhagic cases in stroke patients between 2019 and 2020. There was no noteworthy difference between the stroke case of 2018 and 2019, the comparison of the increase and decrease bar graph was illustrated between 2019 and 2020 only.

Reference

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