Lukas Grassner, Ondra Petr, Freda M. Warner, Michaela Dedeciusova, Andrea Maria Mathis, Daniel Pinggera, Sina Gsellmann, Laura C. Meiners, Sascha Freigang, Michael Mokry, Alexandra Resch, Thomas Kretschmer, Tobias Rossmann, Francisco Ruiz Navarro, Andreas Gruber, Mathias Spendel, Peter A. Winkler, Franz Marhold, Camillo Sherif, Jonathan P. Wais, Karl Rössler, Wolfgang Pfisterer, Manfred Mühlbauer, Felipe A. Trivik-Barrientos, Sebastian Rath, Richard Voldrich, Lukas Krska, Radim Lipina, Martin Kerekanic, Jiri Fiedler, Petr Kasik, Vladimir Priban, Michal Tichy, Petr Krupa, Tomas Cesak, Robert Kroupa, Andrej Callo, Pavel Haninec, Daniel Pohlodek, David Krahulik, Alena Sejkorova, Martin Sames, Josef Dvorak, Petr Suchomel, Robert Tomas, Jan Klener, Vilem Juran, Martin Smrcka, Petr Linzer, Miroslav Kaiser, Dusan Hrabovsky, Radim Jancalek, Vincens Kälin, Oliver Bozinov, Cedric Niggli, Carlo Serra, Ramona Guatta, Dominique E. Kuhlen, Stefan Wanderer, Serge Marbacher, Alexandre Lavé, Karl Schaller, Clarinde Esculier, Andreas Raabe, John L. K. Kramer, Claudius Thomé, and David Netuka
Abstract The world currently faces the novel severe acute respiratory syndrome coronavirus 2 pandemic. Little is known about the effects of a pandemic on non-elective neurosurgical practices, which have continued under modified conditions to reduce the spread of COVID-19. This knowledge might be critical for the ongoing second coronavirus wave and potential restrictions on health care. We aimed to determine the incidence and 30-day mortality rate of various non-elective neurosurgical procedures during the COVID-19 pandemic. A retrospective, multi-centre observational cohort study among neurosurgical centres within Austria, the Czech Republic, and Switzerland was performed. Incidence of neurosurgical emergencies and related 30-day mortality rates were determined for a period reflecting the peak pandemic of the first wave in all participating countries (i.e. March 16th–April 15th, 2020), and compared to the same period in prior years (2017, 2018, and 2019). A total of 4,752 emergency neurosurgical cases were reviewed over a 4-year period. In 2020, during the COVID-19 pandemic, there was a general decline in the incidence of non-elective neurosurgical cases, which was driven by a reduced number of traumatic brain injuries, spine conditions, and chronic subdural hematomas. Thirty-day mortality did not significantly increase overall or for any of the conditions examined during the peak of the pandemic. The neurosurgical community in these three European countries observed a decrease in the incidence of some neurosurgical emergencies with 30-day mortality rates comparable to previous years (2017–2019). Lower incidence of neurosurgical cases is likely related to restrictions placed on mobility within countries, but may also involve delayed patient presentation.