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Multicenter Study
. 2022 Nov:167:e732-e737.
doi: 10.1016/j.wneu.2022.08.082. Epub 2022 Aug 24.

The Effect of COVID-19 National Lockdown on the Time from Presentation to Surgery of Patients with Suspected Cauda Equina Syndrome: Two UK Tertiary Centers' Study

Mohammad Baraka  1 , Adithya Varma  2 , Isaac Mayo  2 , Ravindra Nannapaneni  2 , Stephen McGillion  1 , Emad Shenouda  1 , Ali Nader-Sepahi  1 , Christopher Dare  1 , Malik Zaben  2 , Anan Shtaya  3
Affiliations
Multicenter Study

The Effect of COVID-19 National Lockdown on the Time from Presentation to Surgery of Patients with Suspected Cauda Equina Syndrome: Two UK Tertiary Centers' Study

Mohammad Baraka et al. World Neurosurg. 2022 Nov.

Abstract

Objective: To investigate if COVID-19 UK lockdown measures resulted in a delay in the presentation and treatment of patients with cauda equina syndrome (CES).

Methods: This is a multicenter retrospective study of patients with surgically treated CES across 3 time periods: April-May 2020 (first lockdown), August-September 2020 (no-lockdown group), and January-February 2021 (second lockdown). Data regarding duration of symptoms, time from referral to admission, time from admission to surgery, and postoperative outcomes were collected.

Results: A total of 56 patients (male: 26, female: 30, mean age: 44.3 years) were included in the study (n = 14, n = 18, and n = 24 in the 3 time periods, respectively). There was no significant difference in duration of symptoms across the time periods (12.6 days vs. 8.2 days vs. 3.8 days) (P = 0.16). Nearly all the patients were admitted within 48 hours of referral (n = 55, 98.2%). The majority of patients were operated on within 48 hours: first lockdown (n = 12, 85.7%), no-lockdown (n = 16, 88.9%), and second lockdown (n = 21, 87.5%). The length of hospital stay was significantly shorter in the second lockdown (3.3 days) versus the other 2 time periods (4.4 days and 6.4 days) (P = 0.02). Thirteen complications were present, with dural tear being the most common (n = 6, 10.7%). Majority reported symptom improvement (n = 53, 94.6%), with a similar number discharged home (n = 54, 96.4%).

Conclusion: Despite the pandemic, patients with CES were promptly admitted and operated on with good outcomes. Shorter duration of hospital stay could be attributed to adaptation of spinal services.

Keywords: COVID-19; Cauda equina syndrome; Multicenter; Outcome; Surgical decompression.

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Figures

Figure 1
Figure 1
Breakdown of start of symptoms to presentation to hospital across the studied time periods. Each dot represents a patient.
Figure 2
Figure 2
Time from referral to admission to the neurosurgical ward across the studied time periods.
Figure 3
Figure 3
Time from admission to the neurosurgical/spinal surgery ward to operation across the studied time periods.
Figure 4
Figure 4
Breakdown of length of hospital stay as per the studied time periods.
See this image and copyright information in PMC

References

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