Abstract

The world currently faces the novel severe acute respiratory syndrome coronavirus 2 pandemic. Little is known about the effects of a pandemic on non-elective neurosurgical practices, which have continued under modified conditions to reduce the spread of COVID-19. This knowledge might be critical for the ongoing second coronavirus wave and potential restrictions on health care. We aimed to determine the incidence and 30-day mortality rate of various non-elective neurosurgical procedures during the COVID-19 pandemic. A retrospective, multi-centre observational cohort study among neurosurgical centres within Austria, the Czech Republic, and Switzerland was performed. Incidence of neurosurgical emergencies and related 30-day mortality rates were determined for a period reflecting the peak pandemic of the first wave in all participating countries (i.e. March 16th–April 15th, 2020), and compared to the same period in prior years (2017, 2018, and 2019). A total of 4,752 emergency neurosurgical cases were reviewed over a 4-year period. In 2020, during the COVID-19 pandemic, there was a general decline in the incidence of non-elective neurosurgical cases, which was driven by a reduced number of traumatic brain injuries, spine conditions, and chronic subdural hematomas. Thirty-day mortality did not significantly increase overall or for any of the conditions examined during the peak of the pandemic. The neurosurgical community in these three European countries observed a decrease in the incidence of some neurosurgical emergencies with 30-day mortality rates comparable to previous years (2017–2019). Lower incidence of neurosurgical cases is likely related to restrictions placed on mobility within countries, but may also involve delayed patient presentation.

Details

Title
Trends and outcomes for non-elective neurosurgical procedures in Central Europe during the COVID-19 pandemic
Author
Grassner Lukas 1 ; Ondra, Petr 1 ; Warner, Freda M 2 ; Dedeciusova Michaela 3 ; Mathis, Andrea Maria 4 ; Pinggera, Daniel 1 ; Gsellmann Sina 5 ; Meiners, Laura C 5 ; Freigang Sascha 6 ; Mokry, Michael 6 ; Resch, Alexandra 7 ; Kretschmer, Thomas 7 ; Rossmann, Tobias 8 ; Navarro, Francisco Ruiz 8 ; Gruber, Andreas 8 ; Spendel Mathias 9 ; Winkler, Peter A 9 ; Marhold Franz 10 ; Camillo, Sherif 10 ; Wais, Jonathan P 11 ; Rössler, Karl 11 ; Pfisterer, Wolfgang 12 ; Mühlbauer Manfred 12 ; Trivik-Barrientos, Felipe A 13 ; Rath, Sebastian 13 ; Voldrich, Richard 14 ; Krska Lukas 15 ; Lipina Radim 15 ; Kerekanic Martin 16 ; Fiedler Jiri 16 ; Kasik Petr 17 ; Priban Vladimir 17 ; Tichy Michal 18 ; Krupa Petr 19 ; Cesak Tomas 19 ; Kroupa, Robert 20 ; Callo Andrej 21 ; Haninec Pavel 21 ; Pohlodek, Daniel 22 ; Krahulik, David 22 ; Sejkorova Alena 23 ; Sames, Martin 23 ; Dvorak, Josef 24 ; Suchomel Petr 24 ; Tomas, Robert 25 ; Klener, Jan 25 ; Juran Vilem 26 ; Smrcka, Martin 26 ; Linzer Petr 27 ; Kaiser, Miroslav 28 ; Hrabovsky Dusan 29 ; Jancalek Radim 29 ; Kälin Vincens 30 ; Bozinov Oliver 30 ; Niggli Cedric 31 ; Serra, Carlo 31 ; Guatta Ramona 32 ; Kuhlen, Dominique E 32 ; Wanderer, Stefan 33 ; Marbacher Serge 33 ; Lavé Alexandre 34 ; Schaller, Karl 34 ; Clarinde, Esculier 4 ; Raabe, Andreas 4 ; Kramer John L K 2 ; Thomé Claudius 1 ; Netuka, David 35 

 Medical University Innsbruck, Department of Neurosurgery, Innsbruck, Austria (GRID:grid.5361.1) (ISNI:0000 0000 8853 2677) 
 University of British Columbia, International Collaboration On Repair Discoveries (ICORD), Vancouver, Canada (GRID:grid.17091.3e) (ISNI:0000 0001 2288 9830) 
 Charles University, Central Military Hospital, Department of Neurosurgery and Neuro-Oncology, 1St Medical Faculty, Prague, Czech Republic (GRID:grid.17091.3e) 
 Inselspital Bern, Bern University Hospital, Department of Neurosurgery, Bern, Switzerland (GRID:grid.411656.1) (ISNI:0000 0004 0479 0855) 
 Department of Neurosurgery, Feldkirch, Austria (GRID:grid.5361.1) 
 Medical University Graz, Department of Neurosurgery, Graz, Austria (GRID:grid.11598.34) (ISNI:0000 0000 8988 2476) 
 Department of Neurosurgery & Neurorestauration Klinikum Klagenfurt, Klagenfurt, Austria (GRID:grid.415431.6) (ISNI:0000 0000 9124 9231) 
 Kepler University Hospital GmbH, Johannes Kepler University, Department of Neurosurgery, Linz, Austria (GRID:grid.9970.7) (ISNI:0000 0001 1941 5140) 
 Christian Doppler Clinic, Paracelsus Medical University, Department of Neurosurgery, Salzburg, Austria (GRID:grid.21604.31) (ISNI:0000 0004 0523 5263) 
10  University Hospital of St, Karl Landsteiner University of Health Sciences, Department of Neurosurgery, St. Poelten, Austria (GRID:grid.459693.4) 
11  Medical University of Vienna, Department of Neurosurgery, Vienna, Austria (GRID:grid.22937.3d) (ISNI:0000 0000 9259 8492) 
12  Department of Neurosurgery, Vienna, Austria (GRID:grid.22937.3d) 
13  General Hospital Wiener Neustadt, Department of Neurosurgery, Wiener Neustadt, Austria (GRID:grid.411904.9) (ISNI:0000 0004 0520 9719) 
14  Charles University, Central Military Hospital, Department of Neurosurgery and Neuro-Oncology, 1St Medical Faculty, Prague, Czech Republic (GRID:grid.411904.9) 
15  University Hospital Ostrava, Department of Neurosurgery, Ostrava, Czech Republic (GRID:grid.412727.5) (ISNI:0000 0004 0609 0692) 
16  Ceske Budejovice Hospital, Department of Neurosurgery, Ceske Budejovice, Czech Republic (GRID:grid.412727.5) 
17  Pilsen University Hospital, Department of Neurosurgery, Pilsen, Czech Republic (GRID:grid.412694.c) (ISNI:0000 0000 8875 8983) 
18  Motol University Hospital, Department of Neurosurgery, Motol, Czech Republic (GRID:grid.412826.b) (ISNI:0000 0004 0611 0905) 
19  University Hospital Hradec Kralove, Department of Neurosurgery, Hradec Kralove, Czech Republic (GRID:grid.412539.8) (ISNI:0000 0004 0609 2284) 
20  Municipal Hospital - Ostrava Fifejdy, Unit of Neurosurgery, Ostrava Fifejdy, Czech Republic (GRID:grid.412539.8) 
21  University Hospital Kralovske Vinohrady, Department of Neurosurgery, Prague, Czech Republic (GRID:grid.412819.7) (ISNI:0000 0004 0611 1895) 
22  University Hospital Olomouc, Department of Neurosurgery, Olomouc, Czech Republic (GRID:grid.412730.3) (ISNI:0000 0004 0609 2225) 
23  Usti Nad Labem Hospital, Department of Neurosurgery, Prague, Czech Republic (GRID:grid.412730.3) 
24  Liberec Hospital, Department of Neurosurgery, Prague, Czech Republic (GRID:grid.412730.3) 
25  Homolka Hospital, Unit of Neurosurgery, Prague, Czech Republic (GRID:grid.412730.3) 
26  University Hospital Brno and Masaryk University, Department of Neurosurgery, Prague, Czech Republic (GRID:grid.412730.3) 
27  Zlin Hospital, Unit of Neurosurgery, Prague, Czech Republic (GRID:grid.412730.3) 
28  Pardubice Hospital, Unit of Neurosurgery, Prague, Czech Republic (GRID:grid.412730.3) 
29  St. Anne’s University Hospital Brno and Masaryk University, Department of Neurosurgery, Prague, Czech Republic (GRID:grid.412730.3) 
30  Kantonspital St. Gallen, Department of Neurosurgery, St. Gallen, Switzerland (GRID:grid.412730.3) 
31  University Hospital Zurich, Department of Neurosurgery, Clinical Neuroscience Center, Zurich, Switzerland (GRID:grid.412004.3) (ISNI:0000 0004 0478 9977) 
32  Neurocenter of Southern Switzerland, Clinic of Neurosurgery, Lugano, Switzerland (GRID:grid.469433.f) (ISNI:0000 0004 0514 7845) 
33  Kantonspital Aarau, Department of Neurosurgery, Aarau, Switzerland (GRID:grid.469433.f) 
34  Geneva University Hospitals, Department of Neurosurgery, Geneva, Switzerland (GRID:grid.150338.c) (ISNI:0000 0001 0721 9812) 
35  Charles University, Central Military Hospital, Department of Neurosurgery and Neuro-Oncology, 1St Medical Faculty, Prague, Czech Republic (GRID:grid.5361.1) 
Publication year
2021
Publication date
2021
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2502042776
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.