Declining numbers of neurosurgical emergencies at a German University Medical Center during the coronavirus lockdown

Falter, Johannes; Schebesch, Karl‐Michael; Schmidt, Noemi

doi:10.1016/j.bas.2021.100660

Cited by 2 publications

(2 citation statements)

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“…[25] Another analysis from Germany examined 59 admissions for emergent neurosurgery in the wave 1 of the pandemic and found a decline in total case numbers by 37%. [26] Given that those studies are from single centers and report on neurosurgical emergencies in general, while our study is exclusively on decompressive surgery for stroke, a direct comparison is challenging. Yet, the fact that the larger study from wave 2 of the pandemic found no relevant changes in case load during the pandemic is in line with our findings on decompressive surgery and suggests that neurosurgical care seems to have been somewhat resistant to the negative impact the pandemic had on other medical disciplines.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Decompressive Surgery in the Treatment of Acute Ischemic Stroke during the First Four Waves of the COVID-19 Pandemic in Germany: A Nationwide Observational Cohort Study

Gheewala,

Aldergham,

Rosahl

et al. 2023

J Neurol Surg A Cent Eur Neurosurg

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Background and Study Aims The COVID-19 pandemic has significantly affected acute ischemic stroke (AIS) care. We examined the pandemic’s effects on neurosurgical AIS care by means of decompressive surgery (DS). Patients and Methods In this retrospective observational study, we compared characteristics, in-hospital processes, and in-hospital mortality rates among patients hospitalized for AIS during the first 4 waves of the pandemic (between January 1, 2020, and October 26, 2021) versus corresponding periods in 2019 (pre-pandemic). We used administrative data from a nationwide hospital network in Germany. Results Of the 177 included AIS cases with DS, 60 were from 2019 and 117 from the first 4 pandemic waves. Compared to pre-pandemic levels, there were no changes in weekly admissions for DS during the pandemic. The same was true for patient age (range: 51.7 to 60.4 years), the proportion of female sex (range: 33.3 to 57.1%) and the prevalence of comorbidity, as measured by the Elixhauser comorbidity index (range: 13.2 to 20.0 points). Also, no alterations were observed in transfer to intensive care unit (range: 87.0 to 100%), duration of in-hospital stay (range: 14.6 to 22.7 days), and in-hospital mortality rates (range: 11.8 to 55.6%). Conclusion In Germany, compared to pre-pandemic levels, AIS patients undergoing DS showed no changes in demographics, rates of comorbidity, and in-hospital mortality rates. This is in contrast to previous evidence on patients with less critical types of AIS not requiring DS and underlines the uniqueness of the subgroup of AIS patients requiring DS. Our findings suggests that these patients, in contrast to AIS patients in general, were unable to forgo hospitalization during the COVID-19 pandemic. Maintaining the delivery of DS is an essential aspect of AIS care in times of a pandemic.

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Section: Accepted Manuscriptmentioning

confidence: 99%

Decompressive Surgery in the Treatment of Acute Ischemic Stroke during the First Four Waves of the COVID-19 Pandemic in Germany: A Nationwide Observational Cohort Study

Gheewala,

Aldergham,

Rosahl

et al. 2023

J Neurol Surg A Cent Eur Neurosurg

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“…Many neurological and nonneurological complications have been reported in COVID-19 patients (2). This pandemic led to a marked reduction in the number of spinal and cranial surgeries(3), (4). It is crucial to control this pandemic, but the virus is very contagious and can survive for at least several days on a variety of materials, and there is no effective drug against it to date Without appropriate protection measures, medical professionals could expose the COVID-19 virus.…”

Section: Introductionmentioning

confidence: 99%

Important Finding for COVID-19 Pandemic: Hydrocephalus-producing effect of Vaporized Alcohol Disinfectant

Kanat

Aydın

Şahin

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

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BACKGROUND: Alcohol exposure may cause hydrocephalus. In this study, the effect of vaporized nasal alcohol exposure on the choroid plexus, ependymal cells, and developing hydrocephalus was investigated. METHODS: 24 males (∼380g) Wistar rats were used in this study. Animals were divided into three groups, as the control, SHAM and study groups. Then, the study group was again divided into two groups as exposed to light or heavy dose alcohol. The choroid plexuses and intraventricular ependymal cells and ventricles volumes were assessed and compared. RESULTS: Degenerated epithelial cells density 22±5 /mm3 in the control group, 56±11 /mm3 in the SHAM group, 175±37 /mm3 in the light, and 356±85 /mm3 in the heavy alcohol exposure group. Evan's index was less than <34% in the control, larger than >36% in the SHAM, larger than >40% in the group which was exposed to light alcohol (light alcohol group), larger than >50% in heavy alcohol (heavy alcohol group) exposed. CONCLUSIONS: It was found that alcohol exposure causes choroid plexus and ependymal cell degeneration with ciliopathy and the enlarged lateral ventricles or hydrocephalus. In the COVID-19 Pandemic Era, our findings are functionally important; alcohol has often been used for hygiene and prevention of transmission of COVID-19 pandemic.

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Declining numbers of neurosurgical emergencies at a German University Medical Center during the coronavirus lockdown

Cited by 2 publications

References 0 publications

Decompressive Surgery in the Treatment of Acute Ischemic Stroke during the First Four Waves of the COVID-19 Pandemic in Germany: A Nationwide Observational Cohort Study

Decompressive Surgery in the Treatment of Acute Ischemic Stroke during the First Four Waves of the COVID-19 Pandemic in Germany: A Nationwide Observational Cohort Study

Important Finding for COVID-19 Pandemic: Hydrocephalus-producing effect of Vaporized Alcohol Disinfectant

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