What effect did the New Zealand COVID‐19 lockdown have on computed tomography‐head scan utilisation in patients presenting to the emergency department with traumatic head injuries?

Abstract

AbstractObjectivesTo explore the unique impact the first COVID‐19 national lockdown in New Zealand (NZ) had on the utility of computed tomography (CT)‐head scanning in patients presenting to the ED with head injuries.MethodsRetrospective observational study of CT‐head use in head‐injured patients presenting to the ED during the 2020 COVID‐19 lockdown compared to the corresponding time period in 2019.ResultsDuring the lockdown period in 2020, the total number of ED presentations reduced by 30.3% (95% confidence interval [CI] 28.8–31.6) from 13 477 to 9403. The total number of head injury presentations also reduced by 32% (95% CI 27–36.7) from 523 to 356. The proportion of head‐injured patients remained similar (3.9% [n = 523] in 2019 vs 3.8% [n = 356] in 2020). Of the head injured patients, 185 (51.9%, 95% CI 44.5–59.4) had CT‐head scans performed in 2020 compared to 269 (51.4%, 95% CI 45.2–57.5) in 2019; a reduction of 31.2% (95% CI 24.5–37.9). The proportion of patients who had a CT‐head scan remained similar (51.4% [95% CI 45.2–57.5] in 2019 vs 51.9% [95% CI 44.5–59.4] in 2020). There were no significant differences in the proportion of CT‐head scans with acute traumatic pathology (13.0% [95% CI 8.7–17.3] in 2019 vs 12.4% [95% CI 7.4–17.5] in 2020, P = 0.86).ConclusionsDuring the first COVID‐19 lockdown in NZ, the total number of patients presenting to the ED decreased by one third. Reassuringly, the proportion of patients who presented with head injuries, had a CT‐head scan performed, and had positive CT‐head findings remained the same as the previous year.