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Neurosurgery and coronavirus: impact and challenges—lessons learnt from the first wave of a global pandemic
- Source :
- Acta Neurochirurgica
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Introduction and objectivesThe novel severe acute respiratory syndrome coronavirus 2 (COVID-19) pandemic has had drastic effects on global healthcare with the UK amongst the countries most severely impacted. The aim of this study was to examine how COVID-19 challenged the neurosurgical delivery of care in a busy tertiary unit serving a socio-economically diverse population.MethodsA prospective single-centre cohort study including all patients referred to the acute neurosurgical service or the subspecialty multidisciplinary teams (MDT) as well as all emergency and elective admissions during COVID-19 (18th March 2020–15th May 2020) compared to pre-COVID-19 (18th of January 2020–17th March 2020). Data on demographics, diagnosis, operation, and treatment recommendation/outcome were collected and analysed.ResultsOverall, there was a reduction in neurosurgical emergency referrals by 33.6% and operations by 55.6% during the course of COVID-19. There was a significant increase in the proportion of emergency operations performed during COVID-19 (75.2% of total,n=155) when compared to pre-COVID-19 (n= 198, 43.7% of total,p< 0.00001). In contrast to other published series, the 30-day perioperative mortality remained low (2.0%) with the majority of post-operative COVID-19-infected patients (n= 13) having underlying medical co-morbidities and/or suffering from post-operative complications.ConclusionThe capacity to safely treat patients requiring urgent or emergency neurosurgical care was maintained at all times. Strategies adopted to enable this included proactively approaching the referrers to maintain lines of communications, incorporating modern technology to run clinics and MDTs, restructuring patient pathways/facilities, and initiating the delivery of NHS care within private sector hospitals. Through this multi-modal approach we were able to minimize service disruptions, the complications, and mortality.
- Subjects :
- Male
Emergency Medical Services
medicine.medical_specialty
Neurosurgery
Clinical Neurology
Comorbidity
Global Health
Emergency referrals
Subspecialty
Neurosurgical Procedures
State Medicine
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Multidisciplinary approach
Health care
Pandemic
medicine
Humans
Prospective Studies
030212 general & internal medicine
Pandemics
Referral and Consultation
Patient Care Team
SARS-CoV-2
business.industry
COVID-19
Original Article - Infection
Perioperative
Private sector
United Kingdom
Hospitalization
Coronavirus
Elective Surgical Procedures
Emergency medicine
Female
Interdisciplinary Communication
Surgery
Patient Safety
Neurology (clinical)
business
030217 neurology & neurosurgery
Cohort study
Subjects
Details
- ISSN :
- 09420940 and 00016268
- Volume :
- 163
- Database :
- OpenAIRE
- Journal :
- Acta Neurochirurgica
- Accession number :
- edsair.doi.dedup.....a478fdabe42e16a74eb363e45dcf90cc