Neurosurgery in octogenarians during the COVID-19 pandemic: Results from a tertiary care trauma centre
| Autor: | Anna Rose, Laulwa Al Salloum, Felix Steckler, Aimen Ahmed Osman, Saira Baig, Kevin Agyemang, Christopher Barrett |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Population ageing
medicine.medical_specialty RD1-811 Coronavirus disease 2019 (COVID-19) Referral Outcomes Trauma Tertiary care Pandemic medicine Brain injury RC346-429 business.industry Major trauma Geriatric neurosurgery Referrals medicine.disease Emergency medicine Surgery Neurology. Diseases of the nervous system Neurology (clinical) Neurosurgery Covid-19 business Research Article Cohort study |
| Zdroj: | Interdisciplinary Neurosurgery Interdisciplinary Neurosurgery, Vol 26, Iss, Pp 101357-(2021) |
| ISSN: | 2214-7519 |
| Popis: | Background: \ud In 2020, 6% of Scotland's adult population was ≥80 years. Advancements in care mean improved chances of survival at 6-months for older adults following injury to the brain or spine. The Covid-19 pandemic also resulted in local and national policies aimed at protecting the elderly. We sought to evaluate referral patterns and outcomes for patients ≥80 years referred to our institution during this period.\ud \ud Objective: \ud To evaluate referral patterns and outcomes for patients ≥80 years referred to our institution both before and during the coronavirus pandemic.\ud \ud Design: \ud Retrospective observational cohort study.\ud \ud Setting: \ud Tertiary care in a developing major trauma centre (Queen Elizabeth University Hospital, Glasgow).\ud \ud Participants: \ud All patients ≥80 years referred to the on-call neurosurgical service over two four-month periods before (2016–17; n = 1573) and after the onset of Covid-19 (2020; n = 2014).\ud \ud Methods: \ud Data on demographics, ASA, diagnosis and referral decision were collected. 30-day and 6-month mortality and functional independence were assessed.\ud \ud Results: \ud 246 (before) and 335 (during Covid-19) referred patients were ≥80 years. No gender bias. A significant increase (17%) in acute trauma was seen during the pandemic months. Fewer older adults were transferred (6% to 2% Covid-19) for specialist care, most commonly for chronic subdural haematoma. Most were alive, home and independent at 6 months (47% pre and 63% during Covid-19).\ud \ud Conclusions: \ud Octogenarians feature disproportionately in acute adult neurosurgical referrals. In our department, local and national responses to the Covid-19 pandemic did not appear to influence this. Robust evidence of neurosurgical outcomes in the older adult is required to fairly distribute resources for our ageing population, but decisions must not be based on age alone. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|