BACKGROUND: The COVID19 lockdown has altered the dynamics of living. Its collateral fallout on head injury care has not been studied in detail, especially from low- and middle-income countries, possibly overwhelmed more than developed nations. Here, we analyze the effects of COVID19 restrictions on head injury patients in a high-volume Indian referral trauma center. METHODS: From the prospective trauma registry, clinico-epidemiological and radiological parameters of patients managed during 190 days before and 190 days during COVID19 phases were studied. As an indicator of care, the inpatient mortality of patients with severe HI was also compared with appropriate statistical analyses. RESULTS: Of the total 3372 patients, there were 83 head injury admissions per week before COVID19 restrictions, which decreased to 33 every week (60% drop) during the lock phases and stabilized at 46 per week during the unlock phases. COVID19 restrictions caused a significant increase in the proportion of patients arriving directly without resuscitation at peripheral centers and later than 6 h of injury. Though the most common mechanism was vehicular, a relative increase in the proportion of assaults was noted during COVID19. There was no change in the distribution of mild, moderate, and severe injuries. Despite a decrease in the percentage of patients with systemic illnesses, severe head injury mortality was significantly more during the lock phases than before COVID19 (59% vs. 47%, p = 0.02). CONCLUSIONS: COVID19 restrictions have amplified the already delayed admission among patients of head injury from north-west India. The severe head injury mortality was significantly greater during lock phases than before COVID19, highlighting the collateral fallout of lockdown. Pandemic control measures in the future should not ignore the concerns of trauma emergency care.
BACKGROUND: The COVID19 lockdown has altered the dynamics of living. Its collateral fallout on head injury care has not been studied in detail, especially from low- and middle-income countries, possibly overwhelmed more than developed nations. Here, we analyze the effects of COVID19 restrictions on head injurypatients in a high-volume Indian referral trauma center. METHODS: From the prospective trauma registry, clinico-epidemiological and radiological parameters of patients managed during 190 days before and 190 days during COVID19 phases were studied. As an indicator of care, the inpatient mortality of patients with severe HI was also compared with appropriate statistical analyses. RESULTS: Of the total 3372 patients, there were 83 head injury admissions per week before COVID19 restrictions, which decreased to 33 every week (60% drop) during the lock phases and stabilized at 46 per week during the unlock phases. COVID19 restrictions caused a significant increase in the proportion of patients arriving directly without resuscitation at peripheral centers and later than 6 h of injury. Though the most common mechanism was vehicular, a relative increase in the proportion of assaults was noted during COVID19. There was no change in the distribution of mild, moderate, and severe injuries. Despite a decrease in the percentage of patients with systemic illnesses, severe head injury mortality was significantly more during the lock phases than before COVID19 (59% vs. 47%, p = 0.02). CONCLUSIONS:COVID19 restrictions have amplified the already delayed admission among patients of head injury from north-west India. The severe head injury mortality was significantly greater during lock phases than before COVID19, highlighting the collateral fallout of lockdown. Pandemic control measures in the future should not ignore the concerns of trauma emergency care.
Authors: Patrick G T Walker; Charles Whittaker; Oliver J Watson; Marc Baguelin; Peter Winskill; Arran Hamlet; Bimandra A Djafaara; Zulma Cucunubá; Daniela Olivera Mesa; Will Green; Hayley Thompson; Shevanthi Nayagam; Kylie E C Ainslie; Sangeeta Bhatia; Samir Bhatt; Adhiratha Boonyasiri; Olivia Boyd; Nicholas F Brazeau; Lorenzo Cattarino; Gina Cuomo-Dannenburg; Amy Dighe; Christl A Donnelly; Ilaria Dorigatti; Sabine L van Elsland; Rich FitzJohn; Han Fu; Katy A M Gaythorpe; Lily Geidelberg; Nicholas Grassly; David Haw; Sarah Hayes; Wes Hinsley; Natsuko Imai; David Jorgensen; Edward Knock; Daniel Laydon; Swapnil Mishra; Gemma Nedjati-Gilani; Lucy C Okell; H Juliette Unwin; Robert Verity; Michaela Vollmer; Caroline E Walters; Haowei Wang; Yuanrong Wang; Xiaoyue Xi; David G Lalloo; Neil M Ferguson; Azra C Ghani Journal: Science Date: 2020-06-12 Impact factor: 47.728
Authors: Fachreza Aryo Damara; Galih Ricci Muchamad; Anton Anton; Alfya Nandika Ramdhani; Ivan Christian Channel; Ahmad Faried Journal: World Neurosurg Date: 2022-02-26 Impact factor: 2.210