ABSTRACT
Introduction
Traumatic brain injury (TBI) is amongst the leading causes of morbidity and mortality worldwide. The unprecedented emergence of COVID-19 has mandated neurosurgeons to limit viral spread and spare hospital resources whilst trying to adapt management plans for TBI. We aimed to characterize how this affects decision-making on TBI management and drive strategies to cope with future expected waves.
Methods
Retrospective TBI data collection from a single tertiary referral unit was performed between: 01/04/2019 – 30/06/2019 (‘Pre-Epidemic’) and 01/04/2020 – 30/06/20 (‘Epidemic’). Demographics, mechanism of injury, TBI severity, radiological findings, alcohol/anticoagulants/antiplatelets use, and management decisions were extracted.
Results
646 TBI referrals were received in ‘Pre-Epidemic’ (N = 317) and ‘Epidemic’ (N = 280) groups. There was reduction in RTA-associated TBI (14.8 vs 9.3%; p = .04) and increase in patients on anticoagulants (14.2 vs 23.6%; p = .003) in the ‘Epidemic’ group. Despite similarities between other TBI-associated variables, a significantly greater proportion of patients were managed conservatively in local referring units without neurosurgical services (39.1 vs 56.8%; p < .0001), predominantly constituted by mild TBI.
Conclusion
Despite COVID-19 public health measures, the burden of TBI remains eminent. Increases in local TBI management warrant vigilance from primary healthcare services to meet post-TBI needs in the community.
Data availability
Available on request to corresponding author.
Disclosure statement
The authors report no conflict of interest.
Ethics
This study follows the principles of the Declaration of Helsinki.