Decreased number of deaths related to severe traumatic brain injury in intensive care unit during the first lockdown in Normandy: at least one positive side effect of the COVID-19 pandemic.


Journal

Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000

Informations de publication

Date de publication:
Jul 2021
Historique:
received: 06 02 2021
accepted: 23 03 2021
pubmed: 5 4 2021
medline: 15 7 2021
entrez: 4 4 2021
Statut: ppublish

Résumé

The COVID-19 pandemic has led to severe containment measures to protect the population in France. The first lockdown modified daily living and could have led to a decrease in the frequency of severe traumatic brain injury (TBI). In the present study, we compared the frequency and severity of severe TBI before and during the first containment in Normandy. We included all patients admitted in the intensive care unit (ICU) for severe TBI in the two tertiary neurosurgical trauma centres of Normandy during the first lockdown. The year before the containment served as control. The primary outcome was the number of patients admitted per week in ICU. We compared the demographic characteristics, TBI mechanisms, CT scan, surgical procedure, and mortality rate. The incidence of admissions for severe TBI in Normandy decreased by 33% during the containment. The aetiology of TBI significantly changed during the containment: there were less traffic road accidents and more TBI related to alcohol consumption. Patients with severe TBI during the containment had a better prognosis according to the impact score (p=0.04). We observed a significant decrease in the rate of short-term mortality related to severe TBI during the period of lockdown (p=0.02). Containment related to the COVID-19 pandemic has resulted in a modification of the mechanisms of severe TBI in Normandy, which was associated with a decline in the rate of short-term death in intensive unit care.

Sections du résumé

BACKGROUND BACKGROUND
The COVID-19 pandemic has led to severe containment measures to protect the population in France. The first lockdown modified daily living and could have led to a decrease in the frequency of severe traumatic brain injury (TBI). In the present study, we compared the frequency and severity of severe TBI before and during the first containment in Normandy.
METHODS METHODS
We included all patients admitted in the intensive care unit (ICU) for severe TBI in the two tertiary neurosurgical trauma centres of Normandy during the first lockdown. The year before the containment served as control. The primary outcome was the number of patients admitted per week in ICU. We compared the demographic characteristics, TBI mechanisms, CT scan, surgical procedure, and mortality rate.
RESULTS RESULTS
The incidence of admissions for severe TBI in Normandy decreased by 33% during the containment. The aetiology of TBI significantly changed during the containment: there were less traffic road accidents and more TBI related to alcohol consumption. Patients with severe TBI during the containment had a better prognosis according to the impact score (p=0.04). We observed a significant decrease in the rate of short-term mortality related to severe TBI during the period of lockdown (p=0.02).
CONCLUSIONS CONCLUSIONS
Containment related to the COVID-19 pandemic has resulted in a modification of the mechanisms of severe TBI in Normandy, which was associated with a decline in the rate of short-term death in intensive unit care.

Identifiants

pubmed: 33813617
doi: 10.1007/s00701-021-04831-1
pii: 10.1007/s00701-021-04831-1
pmc: PMC8019477
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1829-1836

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Auteurs

Frederick Rault (F)

Department of Neurosurgery, Caen University Hospital, Avenue de la Côte de Nacre, 14000, Caen, France. rault-f@chu-caen.fr.

Laura Terrier (L)

Department of Neurosurgery, Rouen University Hospital, F-76000, Rouen, France.

Arthur Leclerc (A)

Department of Neurosurgery, Caen University Hospital, Avenue de la Côte de Nacre, 14000, Caen, France.

Vianney Gilard (V)

Department of Neurosurgery, Rouen University Hospital, F-76000, Rouen, France.
Laboratory of Microvascular Endothelium and Neonate Brain Lesions, Normandie Univ, UNIROUEN, INSERM U1245, F-76000, Rouen, France.

Evelyne Emery (E)

Department of Neurosurgery, Caen University Hospital, Avenue de la Côte de Nacre, 14000, Caen, France.
PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Normandie Univ, UNICAEN, INSERM, U1237, Cyceron, 14000, Caen, France.
Medical School, Université Caen Normandie, F-14000, Caen, France.

Stéphane Derrey (S)

Department of Neurosurgery, Rouen University Hospital, F-76000, Rouen, France.

Anaïs R Briant (AR)

Unité de Biostatistique et Recherche Clinique (UBRC), Caen, France.

Clément Gakuba (C)

PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Normandie Univ, UNICAEN, INSERM, U1237, Cyceron, 14000, Caen, France.
Medical School, Université Caen Normandie, F-14000, Caen, France.
Department of Anesthesiology and Critical Care Medicine, CHU de Caen, F-14000, Caen, France.

Thomas Gaberel (T)

Department of Neurosurgery, Caen University Hospital, Avenue de la Côte de Nacre, 14000, Caen, France.
PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Normandie Univ, UNICAEN, INSERM, U1237, Cyceron, 14000, Caen, France.
Medical School, Université Caen Normandie, F-14000, Caen, France.

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