gms | German Medical Science

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

Article

Send article

The effects of the first four COVID-19 waves on decompressive surgery in the treatment of acute ischemic stroke in a nationwide hospital network

Effekte der ersten vier COVID-19-Wellen auf die dekompressive Hemikraniektomie zur Schlaganfallbehandlung in einem deutschlandweiten Krankenhausnetzwerk

Meeting Abstract

Search Medline for

  • presenting/speaker Hussain Gheewala - Helios Klinikum Bad Saarow, Klinik für Neurochirurgie, Bad Saarow, Deutschland; Brandenburg Medical School Theodor Fontane, Bad Saarow, Deutschland
  • Konstantin Prass - Helios Klinikum Bad Saarow, Klinik für Neurologie, Bad Saarow, Deutschland
  • Frederick Palm - Helios Klinik Schleswig, Neurologie, Schleswig, Deutschland
  • Sven Hohenstein - Herzzentrum Leipzig, Leipzig, Deutschland
  • Michael Stoffel - Helios Klinikum Krefeld, Klinik für Neurochirurgie, Krefeld, Deutschland
  • Andreas Meier-Hellmann - Helios Kliniken GmbH, Berlin, Deutschland
  • Ralf Kuhlen - Helios Health GmbH, Berlin, Deutschland
  • Andreas Bollmann - Herzzentrum Leipzig, Leipzig, Deutschland
  • Steffen Rosahl - Helios Klinikum Erfurt, Klinik für Neurochirurgie, Erfurt, Deutschland
  • Julius Dengler - Helios Klinikum Bad Saarow, Klinik für Neurochirurgie, Bad Saarow, Deutschland; Brandenburg Medical School Theodor Fontane, Bad Saarow, 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. DocP220

doi: 10.3205/22dgnc536, urn:nbn:de:0183-22dgnc5362

Published: May 25, 2022

© 2022 Gheewala 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

Text

Objective: In Germany, current evidence shows that acute ischemic stroke (AIS) associated hospitalizations decreased only during the first wave of COVID-19, but not in waves two, three or four. Similarly, the first pandemic wave in Germany was the only one to be associated with an increase in AIS in-hospital mortality rates compared to pre-pandemic levels. This study was conducted to determine the impact of the pandemic on the frequency of decompressive surgery (DS) for AIS and on the characteristics of DS patients.

Methods: We used administrative data (ICD-10 and OPS codes) from a nationwide network of 76 hospitals, representing about 7% of all hospitalizations in Germany, to identify patients with AIS who underwent DS during the first four pandemic waves. Data for each wave was compared to corresponding pre-pandemic phases in 2019. The study was approved by the ethics committee of the coordinating study center (490/20-ek).

Results: During the pandemic, 115 patients underwent DS, compared to 112 pre-pandemic cases. We found no difference in the rates of DS among AIS patients when comparing pandemic to pre-pandemic periods (0.4% each). In the wave-specific analyses, we found that, even though each wave was associated with different total AIS case volumes, none of the pandemic waves produced significant changes in rates or absolute numbers of DS compared to pre-pandemic levels. The absolute numbers of DS were as follows: wave 1: 8 [pandemic] vs. 7 [pre-pandemic; p=0.97]; wave 2: 22 vs. 25 [p=0.78]; wave 3: 21 vs. 26 [p=0.95]; wave 4: 25 vs. 27 [p=0.47]. We observed no differences in patient sex, age distribution, comorbidity profiles, rates of transfer to stroke units, rates of mechanical ventilation, duration of hospital stay and rates of in-hospital mortality among AIS patients with DS in any of the pandemic waves compared to corresponding pre-pandemic levels.

Conclusion: Within this nationwide network of hospitals in Germany, the overall effects of the COVID-19 pandemic on DS in the treatment of AIS were insignificant.