Dynamics in the Neurotrauma Catchment Area of a German University Hospital during the COVID-19 Pandemic

Objective: At the beginning of 2020, the COVID-19 pandemic enforced a rapid reallocation of healthcare resources. Our neurosurgical department is located in the German county of Marburg-Biedenkopf, about 80 km from the nearest major city. We were able to maintain our previously established open-door policy after the emergence of COVID-19. Here, we report on dynamics in the catchment area for neurotrauma patients at our department during the pandemic. Methods: 763 consecutive neurotrauma cases admitted to our department between 1 January 2018 and 31 December 2021 were analyzed retrospectively. Patients' age, gender, origin, diagnoses, and outcomes were recorded. The number of patients hospitalized with a COVID-19 infection in Germany (PHCG) were retrieved from the Robert Koch Institute (RKI). We defined calendar weeks with >1000 PHCG as high COVID-19 caseload weeks (HCLW). Chi-square and Fisher's exact served as statistical tests. Results: In 2020 and 2021, we observed a significantly increased number of neurotrauma patients who, with primary residence outside of our district, were admitted to our hospital compared to 2018 and 2019 (p < 0.001), while there were no significant differences in in-house mortality. During HCLW, a significantly increased number of neurotrauma patients with primary residence in the densely populated southwestern margin (SWM) of the contiguous part of our catchment area were referred to us compared to the time prior to the pandemic and between HCLW (p = 0.003). In neurotrauma patients admitted from the SWM during HCLW, there was no tendency towards higher in-house mortality. Conclusion: An open-door policy may moderate the risk of involuntarily triaging neurotrauma patients during a pandemic.

Automated summary

During the COVID-19 pandemic, our neurosurgical department maintained an open-door policy and admitted more neurotrauma patients from outside our district compared to previous years. There was a significant increase in the number of patients admitted in 2020 and 2021. During high COVID-19 caseload weeks, we observed an increased number of neurotrauma patients from densely populated areas in our catchment area, with no higher in-house mortality observed.