Abstract:
BACKGROUND:To investigate whether patients with critical emergency conditions are seeking or receiving the medical care that they require, we characterized the reality of care for patients presenting with neuro-emergencies during the first phase of the COVID-19 pandemic. METHODS:In this observational, longitudinal cohort study, all neurosurgical admissions that presented to our department between February 1 and April 15 during the COVID-19 pandemic and during the same time period in 2019 were identified and categorized according to the presence of a neuro-emergency, the route of admission, management, and the category of disease. Further, the clinical course of patients with aneurysmal subarachnoid hemorrhage (aSAH) and chronic subdural hematoma (cSDH) was investigated representatively for severe vascular and semi-urgent traumatic conditions that present with a wide variety of symptoms. RESULTS:During the pandemic, the percentage of neuro-emergencies among all neurosurgical admissions remained similar but a larger proportion presented through the emergency department than through the outpatient clinic or by referral (*p = 0.009). The total number of neuro-emergencies was significantly reduced (*p = 0.0007) across all types of disease, particularly in vascular (*p = 0.036) but also in spinal (*p = 0.007) and hydrocephalus (*p = 0.048) emergencies. Patients with spinal emergencies presented 48 h later (*p = 0.001) despite comparable symptom severity. For aSAH, the number of cases, aSAH grade, aneurysm localization, and treatment modality did not change but strikingly, elderly patients with cSDH presented less frequently, with more severe symptoms (*p = 0.046), and were less likely to reach favorable outcome (*p = 0.003) at discharge compared with previous years. CONCLUSIONS:Despite pandemic-related restrictive measures and reallocation of resources, patients with neuro-emergencies should be encouraged to present regardless of the severity of symptoms because deferred presentation may result in adverse outcome. Thus, conservation of critical healthcare resources remains essential in spite of fighting COVID-19.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Hecht N,Wessels L,Werft FO,Schneider UC,Czabanka M,Vajkoczy Pdoi
10.1007/s00701-020-04437-zsubject
Has Abstractpub_date
2020-08-01 00:00:00pages
1795-1801issue
8eissn
0001-6268issn
0942-0940pii
10.1007/s00701-020-04437-zjournal_volume
162pub_type
杂志文章abstract::MRI is routinely used in the evaluation and management of patients with failed back surgery syndrome (FBSS). However, its value is unclear in the early detection of signs that can negatively affect that later course of surgical cases. The purpose of the present study is to describe the MR images of early postoperative...
journal_title:Acta neurochirurgica
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journal_title:Acta neurochirurgica
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pub_type: 杂志文章
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journal_title:Acta neurochirurgica
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journal_title:Acta neurochirurgica
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journal_title:Acta neurochirurgica
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journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
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pub_type: 杂志文章
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更新日期:2009-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2011-04-01 00:00:00
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更新日期:2019-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2000-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:1989-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-06-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
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更新日期:1979-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2012-06-01 00:00:00