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Managing Traumatic Brain Injury During the Coronavirus Disease 2019 Pandemic-A Case-Matched Controlled Analysis of Immediate Outcomes.
Alam, Intekhab; Garg, Kanwaljeet; Raheja, Amol; Tandon, Vivek; Sharma, Ravi; Singh, Manmohan; Singh, Gyaninder Pal; Mishra, Shashwat; Singh, Pankaj Kumar; Agrawal, Deepak; Soni, Kapil Dev; Suri, Ashish; Chandra, Poodipedi Sarat; Kale, Shashank Sharad.
  • Alam I; Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
  • Garg K; Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
  • Raheja A; Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
  • Tandon V; Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India. Electronic address: drtandonvivek@gmail.com.
  • Sharma R; Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
  • Singh M; Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
  • Singh GP; Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
  • Mishra S; Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
  • Singh PK; Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
  • Agrawal D; Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
  • Soni KD; Critical and Intensive Care, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
  • Suri A; Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
  • Chandra PS; Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
  • Kale SS; Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
World Neurosurg ; 165: e59-e73, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1931176
ABSTRACT

OBJECTIVE:

The primary objective of this study was to evaluate the outcome of patients with traumatic brain injury (TBI) during the coronavirus disease 2019 (COVID-19) pandemic and to compare their outcome with case-matched controls from the prepandemic phase.

METHODS:

This is a retrospective case-control study in which all patients with TBI admitted during COVID-19 pandemic phase (Arm A) from March 24, 2020 to November 30, 2020 were matched with age and Glasgow Coma Scale score-matched controls from the patients admitted before March 2020 (Arm B).

RESULTS:

The total number of patients matched in each arm was 118. The length of hospital stay (8 days vs. 5 days; P < 0.001), transit time from emergency room to operation room (150 minutes vs. 97 minutes; P = 0.271), anesthesia induction time (75 minutes vs. 45 minutes; P = 0.002), and operative duration (275 minutes vs. 180 minutes; P = 0.002) were longer in arm A. Although the incidence of fever and pneumonia was significantly higher in arm A than in arm B (50% vs. 26.3%, P < 0.001 and 27.1% vs. 1.7%, P < 0.001, respectively), outcome (Glasgow Outcome Scale-Extended) and mortality (18.6% vs. 14.4% respectively; P = 0.42) were similar in both the groups.

CONCLUSIONS:

The outcome of the patients managed for TBI during the COVID-19 pandemic was similar to matched patients with TBI managed at our center before the onset of the COVID-19 pandemic. This finding suggests that the guidelines followed during the COVID-19 pandemic were effective in dealing with patients with TBI. This model can serve as a guide for any future pandemic waves for effective management of patients with TBI without compromising their outcome.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Brain Injuries, Traumatic / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: World Neurosurg Journal subject: Neurosurgery Year: 2022 Document Type: Article Affiliation country: J.wneu.2022.05.076

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Brain Injuries, Traumatic / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: World Neurosurg Journal subject: Neurosurgery Year: 2022 Document Type: Article Affiliation country: J.wneu.2022.05.076