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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(04): 753-759
DOI: 10.1055/s-0044-1791267
Original Article

The Impact of the Pandemic of COVID-19 on the Head Injury Fast-Track System and Surgical Outcome

Autor*innen

  • Thunya Norasethada

    1   Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand
    2   Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand

  • Kriengsak Limpastan

    1   Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand
    2   Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand

  • Tanat Vaniyapong

    1   Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand
    2   Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand

  • Wanarak Watcharasaksilp

    1   Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand
    2   Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand

  • Chumpon Jetjumnong

    1   Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand
    2   Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand

  • Chanon Srihagulang

    1   Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand
    2   Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand

  • Thanat Kanthawang

    3   Department of Radiology, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand

  • Todsapon Praphanuwat

    1   Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand
    2   Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand

  • Withawat Vuthiwong

    3   Department of Radiology, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand

  • Jirapong Vongsfak 

    1   Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand
    2   Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand
    3   Department of Radiology, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand

Funding This research work was partially supported by faculty of Medicine and Chiang Mai University.
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Abstract

Objective This study aims to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the head injury fast-track system and surgical treatment outcomes.

Materials and Methods A retrospective review was conducted on patients who underwent emergency neurological procedures according to the head injury fast-track system. Data from April 2018 to April 2020 (pre-COVID) were compared with data from May 2020 to May 2022 (during COVID).

Results The analysis comprised 128 patients in the prepandemic group and 119 patients in the pandemic group, with 5 patients diagnosed with COVID infection during the pandemic. Acute subdural hematoma resulting from motorcycle accidents was the most common diagnosis in both groups (56.3 and 47.5%, respectively). The initial Glasgow coma scale (GCS) score was significantly lower during the pandemic compared to the prepandemic period (p = 0.025). Time metrics in the emergency department, including door to computed tomography (CT), emergency room (ER) exit, and incision times, were significantly longer in the pandemic group (p < 0.05). However, there were no statistically significant differences in in-hospital mortality rates (25.8 and 17.7%, respectively; p = 0.12) or the percentage of patients with a favorable functional outcome (Glasgow outcome scale ≥4). At 1 month, a favorable functional outcome was observed in 51.6% of prepandemic patients and 57.1% of pandemic patients (p = 0.69), while at 6 months, the percentages were 56.8 and 64.5%, respectively (p = 0.23).

Conclusions Our study revealed significant delays in hospital processes for head injuries during the COVID-19 pandemic. However, we found no significant impact on mortality rates or functional outcomes of patients.

Keywords

COVID-19 - head injury - severe - fast-track system - neurological outcome - time metrics - traumatic brain injury - pandemic impact

Authors' Contributions

T.N. and J.V. contributed to conceptualization. J.V. performed data collection. J.V., T.N., T.V., K.L., and T.K. performed formal analysis. T.N., J.V., and T.K. contributed to writing the original draft. T.N., K.L., T.V., W.W., C.J., T.P., W.V., C.S., T.K., and J.V. contributed to writing, reviewing, and editing of the manuscript.


Patients' Consent

In accordance with the ethical approval, patient consent was not needed due to the observational nature of the study.




Publikationsverlauf

Artikel online veröffentlicht:
30. September 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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