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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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Neurovascular emergencies during the SARS-CoV2-pandemia at a tertiary medical centre – analysis of incidence and outcome

Neurovaskuläre Notfälle während der SARS-CoV2-Pandemie – Analyse ihres Einflusses auf die Aufnahme in ein tertiäres medizinisches Zentrum

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  • presenting/speaker Konstantinos Lintas - Klinikum Dortmund gGmbH, Neurochirurgie, Dortmund, Deutschland
  • Oliver Müller - Klinikum Dortmund gGmbH, Neurochirurgie, Dortmund, Deutschland
  • Robert Sarge - Klinikum Dortmund gGmbH, Neurochirurgie, Dortmund, Deutschland
  • Boris El Hamalawi - Klinikum Dortmund gGmbH, Neurochirurgie, Dortmund, Deutschland
  • Stephan Rohde - Klinikum Dortmund gGmbH, Radiologie und Neuroradiologie, Dortmund, Deutschland
  • Gisa Ellrichmann - Klinikum Dortmund gGmbH, Neurologie, Dortmund, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocP219

doi: 10.3205/22dgnc535, urn:nbn:de:0183-22dgnc5353

Published: May 25, 2022

© 2022 Lintas et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: To assess the impact of the lockdown in Germany due to the SARS-CoV2-pandemic on the incidence and the outcome of neurovascular emergencies at a tertiary medical center.

Methods: We performed a matched-case-study on neurovascular emergencies treated between March 16th 2020 and January 31st 2021, beginning of the first lock down to the near-end of the second lockdown in Germany. Cases were retrospectively analysed with respect to incidence and outcome, and finally compared to a matching cohort of cases between March 16th 2019 to January 31st 2020.

Results: A total of 764 neurosurgical emergencies were admitted to our hospital between March 16th 2019 and January 31st 2020 (the matched-case-control group). Of these, 95 cases were identified as neurovascular cases. Amongst, there were 39 symptomatic aneurysms, 3 AVMs, 12 non-traumatic subarachnoid hemorrhages without identifiable bleeding source, 30 non-traumatic intracerebral hemorrhages or hematocephaluses, 10 chronic subdural hemorrhages and 1 symptomatic AVF.

During the period of the pandemic from March 16th 2020 to January 31st 2021, there were 905 neurosurgical emergencies (an increase of 18%) referred to our hospital. Of these, 123 neurovascular emergencies were identified (+29%). There were 47 symptomatic aneurysms (increase +20%) admitted, 5 AVMS (+66%), 9 non-traumatic subarachnoid hemorrhages without identifiable bleeding source (-25%), 40 non-traumatic intracerebral hemorrhages or hematocephaluses (+54 +33,3%), 19 chronic subdural hemorrhages (+90%) and 3 symptomatic AVF.

Mortality rate increased dramatically by 40% during the pandemic throughout all neurovascular cases.

Conclusion: Unexpectedly, in our study neurovascular cases raised in number and severity during the pandemic in Germany. Furthermore, the case fatality increased. The later may be explained by two circumstances during the lowckdown period. First, patients refused to seek medical help by their family physician while suffering only mild symptoms. Secondly, the referral times of patients in need of neurosurgical attention was much longer due to restricted admission at lower-level medical centers. In a pandemic situation like the SARS-CoV2/COVID-19 it seems of utmost importance to retain dedicated neurovascular competence in designated centers to care for these emergencies.