TY  - JOUR
PY  - 2022//
TI  - Trends in neurotrauma epidemiology, management, and outcomes during the COVID-19 pandemic in Kigali, Rwanda
JO  - Journal of neurotrauma
A1  - Tang, Oliver Young
A1  - Uwamahoro, Chantal
A1  - González Marqués, Catalina
A1  - Beeman, Aly
A1  - Odoom, Enyonam
A1  - Ndebwanimana, Vincent
A1  - Uwamahoro, Doris
A1  - Niyonsaba, Mediatrice
A1  - Nzabahimana, Apollinaire
A1  - Munyanziza, Silas
A1  - Nshuti, Steven
A1  - Jarmale, Spandana
A1  - Stephen, Andrew
A1  - Aluisio, Adam
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: National regulations to curb COVID-19 transmission and healthcare resource reallocation may have impacted incidence and treatment for neurotrauma, including traumatic brain injury (TBI) and spinal trauma, but these trends have not been characterized in Sub-Saharan Africa. This study analyzes differences in epidemiology, management, and outcomes preceding and during the COVID-19 pandemic for neurotrauma patients in a Rwandan tertiary hospital. <br><br>METHODS: The study setting was Centre Hospitalier Universitaire de Kigali (CHUK), Rwanda's national referral hospital. Adult injury patients presenting to the CHUK Emergency Department were prospectively enrolled from 1/27/20-6/28/20. Study personnel collected data on demographics, injury characteristics, serial neurological examinations, treatment, and outcomes. Differences in patients before (1/27/20-3/22/20) and during (6/1/20-6/28/20) the COVID-19 pandemic were assessed using chi-squared and Mann-Whitney tests. <br><br>RESULTS: The study population included 216 neurotrauma patients (83.8% TBI, 8.3% spine trauma, and 7.9% with both). Mean age was 34.1 years (standard deviation=12.5) and 77.8% were male. Patients predominantly experienced injury following road traffic accident (65.7%). Weekly volume for TBI (mean=16.5 vs. 17.1, P=0.819) and spine trauma (mean=2.0 vs. 3.4, P=0.086) was similar between study periods. During the pandemic, patients had lower GCS (mean=13.8 vs. 14.3, P=0.068) and Kampala Trauma Scores (mean=14.0 vs. 14.3, P=0.097) on arrival, denoting higher injury severity, but these differences only approached significance. Patients treated during the pandemic period had higher occurrence of hemorrhage, contusion, or fracture on CT imaging (47.1% vs. 26.7%, P=0.003) and neurologic decline (18.6% vs. 7.5%, P=0.016). Hospitalizations also increased significantly during COVID-19 (54.6% vs. 39.9%, P=0.048). Craniotomy rates doubled during the pandemic period (25.7% vs. 13.7%, P=0.003), but mortality was unchanged (5.5% vs. 5.7%, P=0.944). <br><br>CONCLUSIONS: Neurotrauma volume remained unchanged at CHUK during the COVID-19 pandemic, but presenting patients had higher injury acuity and craniotomy rates. These findings may inform care during pandemic conditions in Rwanda and similar settings.<p />  <p>Language: en</p>
LA  - en
SN  - 0897-7151
UR  - http://dx.doi.org/10.1089/neu.2022.0166
ID  - ref1
ER  -