Impact of the COVID-19 Pandemic on Traumatic Brain Injury Care: Analysis from a Tertiary Emergency Center in Japan

This study aimed to assess the impact of the COVID-19 pandemic on head trauma care at an advanced emergency medical center. We retrospectively analyzed 471 consecutive head injury cases between January 2017 and October 2022. The pre-pandemic group included 236 cases transported between January 2017 and December 2019, while the during-pandemic group included 235 cases between January 2020 and October 2022. Characteristics of the patients, mechanism of injury, Injury Severity Score, trunk injury status, transport time, neurosurgical intervention, and modified Rankin Scale (mRS) score 3 months after injury were compared between the two groups. The average age of the 471 patients was 51.3 +/- 25.9 years (2-97), including 166 severe cases (35.2%). One hundred and fifty-three patients (32.5%) underwent neurosurgical intervention, and 51 (10.8%) died after 3 months. Results of the comparison between the pre-pandemic and during-pandemic groups showed the proportion of traffic injuries (46.6% vs. 37.0%, p = 0.035), severe cases (Glasgow Coma Scale score <= 8, 39.8% vs. 30.6%, p = 0.036), and neurosurgical intervention (41.5% vs. 23.4%, p < 0.001) decreased. The average transport time for all head injuries was longer (32.8 min vs. 37.5 min, p = 0.0029); however, no significant difference was observed in an analysis focused only on severe cases (29.7 min vs. 34.3 min, p = 0.060). After 3 months, there was no significant difference in the mRS score (p = 0.82) or mortality rate (p = 0.45). The study findings suggest that, in the next pandemic, conducting effective triage in the prehospital setting and ensuring rapid emergency transport may help keep the prognostic outcome, especially for severe cases.