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. 2022 Jul:101:131-136.
doi: 10.1016/j.jocn.2022.04.033. Epub 2022 May 2.

Impact on neurosurgical management in a Level 1 trauma center post COVID-19 shelter-in-place restrictions

Michael Zhang  1 , James Zhou  2 , Benjamin Dirlikov  3 , Tene Cage  4 , Marco Lee  4 , Harminder Singh  5
Affiliations

Impact on neurosurgical management in a Level 1 trauma center post COVID-19 shelter-in-place restrictions

Michael Zhang et al. J Clin Neurosci. 2022 Jul.

Abstract

The stringent restrictions from shelter-in-place (SIP) policies placed on hospital operations during the COVID-19 pandemic led to a sharp decrease in planned surgical procedures. This study quantifies the surgical rebound experienced across a neurosurgical service post SIP restrictions in order to guide future hospital programs with resource management. We conducted a retrospective review of all neurosurgical procedures at a public Level 1 trauma center between February 15th to August 30th for the years spanning 2018-2020. We categorized patient procedures into four comparative one-month periods: pre-SIP; SIP; post-SIP; and late recovery. Patient procedures were designated as either cranial; spinal; and other; as well as Elective or Add-on (Urgent/Emergent). Categorical variables were analyzed using χ2 tests and Fisher's exact tests. A total of 347 cases were reviewed across the four comparative periods and three years studied; with 174 and 152 spinal and cranial procedures; respectively. There was a proportional increase; relative to historical controls; in total spinal procedures (p-value < 0.001) and elective spinal procedures (p-value < 0.001) in the 2020 SIP to Post-SIP. The doubling of elective spinal cases in the Post-SIP period returned to historical baseline levels in three months after SIP restrictions were lifted. Total cranial procedures were proportionally increased during the SIP period relative to historical controls (p-value = 0.005). We provide a census on the post-pandemic neurosurgical operative demands at a major public Level 1 trauma hospital, which can potentially be applied for resource allocations in other disaster scenarios.

Keywords: COVID-19; Cranial; Elective; Neurosurgery; Shelter-in-place; Spine.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Line graph depicting the total case counts at Santa Clara Valley Medical Center during the Pre-SIP; SIP; Post-SIP; and Late phases for years 2018–2020. SIP; shelter-in place.
Fig. 2
Fig. 2
Line graphs depicting the census of cranial and spinal surgeries during the Pre-SIP; SIP; Post-SIP; and Late phases for years 2018–2020. A) Total volume of cranial surgeries. B) Total volume of spinal surgeries. C) Proportion of total cases which were cranial surgeries. D) Proportion of total cases which were spinal surgeries. SIP; shelter-in place.
Fig. 3
Fig. 3
Line graphs depicting the census of Elective and Add-on surgeries; either cranial or spinal during the Pre-SIP; SIP; Post-SIP; and Late phases for years 2018–2020. A) Total volume of Elective cranial surgeries. B) Total volume of Elective spinal surgeries. C) Total volume of Add-on cranial surgeries. D) Total volume of Add-on spinal surgeries. SIP; shelter-in place.
Fig. 4
Fig. 4
Pie charts depicting the proportion of total hospital billing; categorized by indication (Cranial; Spinal; or Other) and Scheduling Status (Elective; Add-on). A) Hospital billing during the Pre-SIP time period. B) Hospital billing during the SIP time period. C) Hospital billing during the Post-SIP time period. D) Hospital billing during the Late time period. SIP; shelter-in place.
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References

    1. Figueroa J.M., Boddu J., Kader M., Berry K., Kumar V., Ayala V., et al. The Effects of Lockdown During the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic on Neurotrauma-Related Hospital Admissions. World Neurosurg. 2021;146:e1–e5. - PMC - PubMed
    1. Jean W.C., Ironside N.T., Sack K.D., Felbaum D.R., Syed H.R. The impact of COVID-19 on neurosurgeons and the strategy for triaging non-emergent operations: a global neurosurgery study. Acta Neurochir. 2020;162(6):1229–1240. - PMC - PubMed
    1. Koester S.W., Catapano J.S., Ma K.L., Kimata A.R., Abbatematteo J.M., Walker C.T., et al. COVID-19 and Neurosurgery Consultation Call Volume at a Single Large Tertiary Center With a Propensity-Adjusted Analysis. World Neurosurg. 2021;146:e768–e772. - PMC - PubMed
    1. Raneri F., Rustemi O., Zambon G., Del Moro G., Magrini S., Ceccaroni Y., et al. Neurosurgery in times of a pandemic: a survey of neurosurgical services during the COVID-19 outbreak in the Veneto region in Italy. Neurosurg Focus FOC. 2020;49(6):E9. - PubMed
    1. Saad H., Alawieh A., Oyesiku N., Barrow D.L., Olson J. Sheltered Neurosurgery During COVID-19: The Emory Experience. World Neurosurg. 2020;144:e204–e209. - PMC - PubMed