Neurosurgical emergency management during the lockdown period in health care regions in Spain with different COVID-19 impact: lessons learned to improve outcomes on the future waves.

Autor: Gandía-González ML; Department of Neurosurgery, La Paz University Hospital, Idipaz, Paseo de La Castellana, 261, 28046, Madrid, Spain. marisagg4@hotmail.com., Viñuela-Prieto JM; Department of Neurosurgery, La Paz University Hospital, Idipaz, Paseo de La Castellana, 261, 28046, Madrid, Spain., Barrios L; Department of Statistics CSIC, Madrid, Spain., Alarcón C; Department of Neurosurgery, Hospital de Terrassa, Terrassa, Spain., Arikan F; Department of Neurosurgery, Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron University Hospital and Vall d'Hebron Research Institute, Barcelona, Spain., Arráez C; Department of Neurosurgery, Carlos Haya University Hospital, Málaga, Spain., Domínguez CJ; Department of Neurological Surgery, Germans Trias i Pujol University Hospital, Badalona, Spain., Alén JF; Department of Neurosurgery, La Princesa University Hospital, Madrid, Spain., Gutiérrez-González R; Department of Neurosurgery, Puerta de Hierro University Hospital, Madrid, Spain.; Department of Surgery, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain., Horcajadas A; Neurosurgery Department, Virgen de las Nieves University Hospital, Granada, Spain., Muñoz Hernández F; Neurosurgery, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain., Narváez A; Department of Neurosurgery, Parc de Salut Mar, Barcelona, Spain., Paredes I; Neurosurgery Department, Hospital 12 de Octubre, Madrid, Spain., Pérez-Alfayate R; Department of Neurological Surgery, Hospital Clínico San Carlos, Madrid, Spain., Rodríguez de Lope A; Department of Neurosurgery, Virgen de la Salud Hospital, Toledo, Spain., Ruiz-Juretschke F; Department of Neurosurgery, Hospital General Universitario Gregorio Marañón, Madrid, Spain., Salge Arrieta FJ; Department of Neurosurgery, Ramón y Cajal University Hospital, Madrid, Spain., Tejada S; Department of Neurosurgery, Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain., Tamarit M; Department of Neurosurgery, Hospital Universitario de Getafe, Getafe, Spain., Topczewski T; Department of Neurological Surgery, Hospital Clinic, Barcelona, Spain., Lafuente J; Department of Neurosurgery, Parc de Salut Mar, Barcelona, Spain.
Jazyk: angličtina
Zdroj: European journal of trauma and emergency surgery : official publication of the European Trauma Society [Eur J Trauma Emerg Surg] 2022 Jun; Vol. 48 (3), pp. 2189-2198. Date of Electronic Publication: 2021 Aug 16.
DOI: 10.1007/s00068-021-01767-0
Abstrakt: Background: COVID-19 has overloaded health care systems, testing the capacity and response in every European region. Concerns were raised regarding the impact of resources' reorganization on certain emergency pathology management. The aim of the present study was to assess the impact of the outbreak (in terms of reduction of neurosurgical emergencies) during lockdown in different regions of Spain.
Methods: We analyzed the impact of the outbreak in four different affected regions by descriptive statistics and univariate comparison with same period of two previous years. These regions differed in their incidence level (high/low) and in the time of excess mortality with respect to lockdown declaration. That allowed us to analyze their influence on the characteristics of neurosurgical emergencies registered for every region.
Results: 1185 patients from 18 neurosurgical centers were included. Neurosurgical emergencies that underwent surgery dropped 24.41% and 28.15% in 2020 when compared with 2019 and 2018, respectively. A higher reduction was reported for the most affected regions by COVID-19. Non-traumatic spine experienced the most significant decrease in number of cases. Life-threatening conditions did not suffer a reduction in any health care region.
Conclusions: COVID-19 affected dramatically the neurosurgical emergency management. The most significant reduction in neurosurgical emergencies occurred on those regions that were hit unexpectedly by the pandemic, as resources were focused on fighting the virus. As a consequence, life-threating and non-life-threatening conditions' mortality raised. Results in regions who had time to prepare for the hit were congruent with an organized and sensible neurosurgical decision-making.
(© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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