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Time Series Analysis of Head Injury during Pandemic

Lekhansh Shukla
Published: 7 April 2021
doi:10.31219/osf.io/p36at
Abstract: Introduction: Traumatic Brain Injury (TBI) is the most important cause of neurological disability worldwide. This study aims to find a change in TBI pattern during the coronavirus disease (COVID 19) pandemic.Methods: We have collected the number of TBI cases seen every day between 01/12/19 and 03/01/21 (400 days) in the emergency department of a tertiary neuropsychiatric centre in Bangalore and estimated a changepoint. Two predictors of this change — community mobility data from Google mobility reports (pre-processed with principal component analysis) and alcohol sales data from the wholesaler are examined. A time-series model using generalised linear regression for scale and shape is fit, and bootstrap confidence intervals are used for inference. We have compared the clinical details — mode and severity of the injury, compliance with safety regulations, age, residence and gender of patients seen before and after the changepoint.Results: An optimal changepoint is detected on 20/03/20 following which the mean number of TBI cases seen every day has decreased and variance has increased (Mean 1 = 29.4, Variance 1 = 50.1; Mean 2 = 19.5, Variance 2 = 59.7, Loglikelihood Ratio Test: χ2 = 130, df = 1, p < 0.001). Two principal components of community mobility, alcohol sales and weekday, explain the change in the number of TBI cases (Pseudo R-square = 58.1). A significant decrease in traffic accidents, falls, mild/moderate injuries, but an increase in assault and severe injuries is seen during the pandemic period.Conclusions: Decongestion of roads and regulation of alcohol sales can decrease TBI occurrence substantially. An increase in violent trauma during lockdown needs further research in the light of domestic violence. Acute care facilities for TBI should be maintained even during a strict lockdown as the proportion of severe TBI requiring admission increases.
Keywords: safety / alcohol / model / mobility / TBI / optimal / severity of the injury / Pandemic / roads / Variance

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