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The collateral fallout of COVID19 lockdown on patients with head injury from north-west India

Acta Neurochirurgica volume 163, pages 1053–1060 (2021)Cite this article

Abstract

Background

The COVID19 lockdown has altered the dynamics of living. Its collateral fallout on head injury care has not been studied in detail, especially from low- and middle-income countries, possibly overwhelmed more than developed nations. Here, we analyze the effects of COVID19 restrictions on head injury patients in a high-volume Indian referral trauma center.

Methods

From the prospective trauma registry, clinico-epidemiological and radiological parameters of patients managed during 190 days before and 190 days during COVID19 phases were studied. As an indicator of care, the inpatient mortality of patients with severe HI was also compared with appropriate statistical analyses.

Results

Of the total 3372 patients, there were 83 head injury admissions per week before COVID19 restrictions, which decreased to 33 every week (60% drop) during the lock phases and stabilized at 46 per week during the unlock phases. COVID19 restrictions caused a significant increase in the proportion of patients arriving directly without resuscitation at peripheral centers and later than 6 h of injury. Though the most common mechanism was vehicular, a relative increase in the proportion of assaults was noted during COVID19. There was no change in the distribution of mild, moderate, and severe injuries. Despite a decrease in the percentage of patients with systemic illnesses, severe head injury mortality was significantly more during the lock phases than before COVID19 (59% vs. 47%, p = 0.02).

Conclusions

COVID19 restrictions have amplified the already delayed admission among patients of head injury from north-west India. The severe head injury mortality was significantly greater during lock phases than before COVID19, highlighting the collateral fallout of lockdown. Pandemic control measures in the future should not ignore the concerns of trauma emergency care.

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Affiliations

  1. Department of Neurosurgery, Postgraduate Institute of Medical Education & Research (PGIMER), Sector 12, Chandigarh, 160012, India

    Madhivanan Karthigeyan, Sivashanmugam Dhandapani, Pravin Salunke, Sushanta K. Sahoo, Mandeep S. Kataria, Apinderpreet Singh, Chandrashekhar Gendle, Chirag Panchal, Rajesh Chhabra & Sunil K. Gupta

  2. Department of Anesthesia, Postgraduate Institute of Medical Education & Research (PGIMER), Sector 12, Chandigarh, 160012, India

    Kajal Jain

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  1. Madhivanan Karthigeyan
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  2. Sivashanmugam Dhandapani
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Correspondence to Sivashanmugam Dhandapani.

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The procedures performed were as per the ethical standards of the institutional ethics committee and with the 1964 Helsinki declaration and its later amendments. For this type of study, formal consent is not required.

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Karthigeyan, M., Dhandapani, S., Salunke, P. et al. The collateral fallout of COVID19 lockdown on patients with head injury from north-west India. Acta Neurochir 163, 1053–1060 (2021). https://doi.org/10.1007/s00701-021-04723-4

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Keywords

  • COVID
  • Head injury
  • Lockdown
  • Traumatic brain injury
  • Lower-middle income
  • Developing country
  • Neurotrauma