1. Impact of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients: a nationwide study in Spain
- Author
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Igor Paredes, Ana Maria Castaño Leon, Alfonso Lagares, Luis Jimenez Roldan, Angel Perez-Nuñez, Pedro González-Leon, Juan Delgado-Fernandez, Carla Eiriz, Daniel García-Pérez, Luis Miguel Moreno-Gomez, Olga Esteban-Sinovas, Pedro Delgado-López, Javier Martín-Alonso, Ariel Kaen, Jorge Tirado-Caballero, Marta Ordóñez Carmona, Francisco Arteaga Romero, Marta Gonzalez Pombo, José F Alén, Ricardo Gil-Simoes, Cristina V Torres, Marta Navas Garcia, Guillermo Blasco, Natalia Frade-Porto, Patricia González-Tarno, Adrian Martin Segura, Miguel Gelabert-Gonzalez, Beatriz Menendez Cortezon, Brais Rodriguez Botana, Rebeca Pérez-Alfayate, Carla Fernandez Garcia, Borja Ferrandez Pujante, Andres Vargas-Jiménez, Carlos Cotúa, Adolfo de la Lama, Lourdes Calero, Fernando Ruiz-Juretschke, Roberto Garcia Leal, Marc Valera Mele, Vicente Casitas Hernando, Belén Rivero Martín, Javier Orduna, Juan Casado Pellejero, David Fustero De Miguel, Jorge Diaz-Molina, Jesus Moles Herbera, Maria Jose Castello Ruiz, Mario Gomar Alba, Fernando Garcia Perez, Borja Jesus Hernandez Garcia, Javier Villaseñor Ledezma, Álvaro Otero Rodríguez, Juan José Ailagas, Jesús Goncalves-Estella, Pablo Sousa Casasnovas, Daniel Pascual Argente, Laura Ruiz Martín, Juan Carlos Roa Montes de Oca, Daniel Arandia Guzmán, Andoni García Martín, Luis Torres Carretero, Patricia Alejandra Garrido Ruíz, Marta Calvo, Pablo Miranda-Lloret, Miguel Rodriguez-Cadarso Suarez-Vence, Joan Anotn Oltra, Amparo Roca Barber, Arnold Quiroz Tejada, Guillermo Carbayo Lozano, Garazi Bermudez Vilar, Clara Paternain Martin, Pablo Dela FuenteVilla, Marina Fidalgo De la Rosa, Íñigo L Sistiaga García, and Gorka Zabalo San Juan
- Subjects
SARS-CoV-2 ,Spain ,COVID-19 ,Humans ,General Medicine ,adult surgery ,Pandemics ,neurological oncology ,Retrospective Studies ,neurological injury ,neurosurgery - Abstract
ObjectiveTo assess the effect of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients in Spain.SettingsThe initial flood of COVID-19 patients overwhelmed an unprepared healthcare system. Different measures were taken to deal with this overburden. The effect of these measures on neurosurgical patients, as well as the effect of COVID-19 itself, has not been thoroughly studied.ParticipantsThis was a multicentre, nationwide, observational retrospective study of patients who underwent any neurosurgical operation from March to July 2020.InterventionsAn exploratory factorial analysis was performed to select the most relevant variables of the sample.Primary and secondary outcome measuresUnivariate and multivariate analyses were performed to identify independent predictors of mortality and postoperative SARS-CoV-2 infection.ResultsSixteen hospitals registered 1677 operated patients. The overall mortality was 6.4%, and 2.9% (44 patients) suffered a perioperative SARS-CoV-2 infection. Of those infections, 24 were diagnosed postoperatively. Age (OR 1.05), perioperative SARS-CoV-2 infection (OR 4.7), community COVID-19 incidence (cases/105people/week) (OR 1.006), postoperative neurological worsening (OR 5.9), postoperative need for airway support (OR 5.38), ASA grade ≥3 (OR 2.5) and preoperative GCS 3–8 (OR 2.82) were independently associated with mortality. For SARS-CoV-2 postoperative infection, screening swab test 5people/week) (OR 1.011), preoperative cognitive impairment (OR 2.784), postoperative sepsis (OR 3.807) and an absence of postoperative complications (OR 0.188) were independently associated.ConclusionsPerioperative SARS-CoV-2 infection in neurosurgical patients was associated with an increase in mortality by almost fivefold. Community COVID-19 incidence (cases/105people/week) was a statistically independent predictor of mortality.Trial registration numberCEIM 20/217.
- Published
- 2021