1. Impact of COVID-19 on a Neurosurgical Service: Lessons from the University of California San Diego
- Author
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Christopher A. Longhurst, Lauren E Stone, Jeffrey A. Steinberg, William R. Taylor, Arvin R. Wali, Keiko Kang, Luis Daniel Diaz-Aguilar, David R Santiago-Dieppa, Bryan Ryba, Michael G. Brandel, and Alexander A. Khalessi
- Subjects
essential ,Operating Rooms ,LP, lumboperitoneal ,California ,Neurosurgical Procedures ,law.invention ,Hospitals, University ,0302 clinical medicine ,law ,Epidemiology ,elective ,Academic Medical Centers ,Brain Neoplasms ,Endovascular Procedures ,Intensive care unit ,EEA, endoscopic endonasal approach ,ICU, intensive care unit ,Cerebrospinal Fluid Shunts ,Organizational Policy ,Intensive Care Units ,Elective Surgical Procedures ,030220 oncology & carcinogenesis ,COVID-19 Nucleic Acid Testing ,Original Article ,Neurosurgery ,Medical emergency ,VPS, ventriculoperitoneal shunt ,Risk assessment ,Elective Surgical Procedure ,operative volume ,Vascular Surgical Procedures ,PPE, personal protective equipment ,medicine.medical_specialty ,Clinical Neurology ,Hospital Departments ,Risk Assessment ,COVID-19 Serological Testing ,03 medical and health sciences ,IR, interventional radiology ,medicine ,OR, operating room ,Humans ,Personal protective equipment ,Personal Protective Equipment ,Retrospective Studies ,ESI, epidural steroid injection ,Infection Control ,Multi-Institutional Systems ,Ventilators, Mechanical ,business.industry ,Information Dissemination ,SARS-CoV-2 ,CT, computer tomography ,Surge Capacity ,COVID-19 ,Retrospective cohort study ,medicine.disease ,UC, University of California ,Laboratories, Hospital ,Triage ,Hospital Bed Capacity ,Wounds and Injuries ,Surgery ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
BACKGROUND: The institution-wide response of the University of California San Diego Health system to the 2019 novel coronavirus disease (COVID-19) pandemic was founded on rapid development of in-house testing capacity, optimization of personal protective equipment usage, expansion of intensive care unit capacity, development of analytic dashboards for monitoring of institutional status, and implementation of an operating room (OR) triage plan that postponed nonessential/elective procedures. We analyzed the impact of this triage plan on the only academic neurosurgery center in San Diego County, California, USA. METHODS: We conducted a de-identified retrospective review of all operative cases and procedures performed by the Department of Neurosurgery from November 24, 2019, through July 6, 2020, a 226-day period. Statistical analysis involved 2-sample z tests assessing daily case totals over the 113-day periods before and after implementation of the OR triage plan on March 16, 2020. RESULTS: The neurosurgical service performed 1429 surgical and interventional radiologic procedures over the study period. There was no statistically significant difference in mean number of daily total cases in the pre-versus post-OR triage plan periods (6.9 vs. 5.8 mean daily cases; 1-tail P = 0.050, 2-tail P = 0.101), a trend reflected by nearly every category of neurosurgical cases. CONCLUSIONS: During the COVID-19 pandemic, the University of California San Diego Department of Neurosurgery maintained an operative volume that was only modestly diminished and continued to meet the essential neurosurgical needs of a large population. Lessons from our experience can guide other departments as they triage neurosurgical cases to meet community needs.
- Published
- 2020