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Tracking the Volume of Neurosurgical Care During the Coronavirus Disease 2019 Pandemic
Journal article   Open access   Peer reviewed

Tracking the Volume of Neurosurgical Care During the Coronavirus Disease 2019 Pandemic

Pious D. Patel, Katherine A. Kelly, Rebecca A. Reynolds, Robert W. Turer, Sanjana Salwi, S. Trent Rosenbloom, Christopher M. Bonfield and Robert P. Naftel
World neurosurgery, Vol.142, pp.e183-e194
10/01/2020
DOI: 10.1016/j.wneu.2020.06.176
PMCID: 7319935
PMID: 32599201
url
https://doi.org/10.1016/j.wneu.2020.06.176View
Published (Version of record) Open Access

Abstract

In the present study, we quantified the effect of the coronavirus disease 2019 (COVID-19) on the volume of adult and pediatric neurosurgical procedures, inpatient consultations, and clinic visits at an academic medical center. Neurosurgical procedures, inpatient consultations, and outpatient appointments at Vanderbilt University Medical Center were identified from March 23, 2020 through May 8, 2020 (during COVID-19) and March 25, 2019 through May 10, 2019 (before COVID-19). The neurosurgical volume was compared between the 2 periods. A 40% reduction in weekly procedural volume was demonstrated during COVID-19 (median before, 75; interquartile range [IQR], 72–80; median during, 45; IQR, 43–47; P < 0.001). A 42% reduction occurred in weekly adult procedures (median before, 62; IQR, 54–70; median during, 36; IQR, 34–39; P < 0.001), and a 31% reduction occurred in weekly pediatric procedures (median before, 13; IQR, 12–14; median during, 9; IQR, 8–10; P = 0.004). Among adult procedures, the most significant decreases were seen for spine (P < 0.001) and endovascular (P < 0.001) procedures and cranioplasty (P < 0.001). A significant change was not found in the adult open vascular (P = 0.291), functional (P = 0.263), cranial tumor (P = 0.143), or hydrocephalus (P = 0.173) procedural volume. Weekly inpatient consultations to neurosurgery decreased by 24% (median before, 99; IQR, 94–114; median during, 75; IQR, 68–84; P = 0.008) for adults. Weekly in-person adult and pediatric outpatient clinic visits witnessed a 91% decrease (median before, 329; IQR, 326–374; median during, 29; IQR, 26–39; P < 0.001). In contrast, weekly telehealth encounters increased from a median of 0 (IQR, 0–0) before to a median of 151 (IQR, 126–156) during COVID-19 (P < 0.001). Significant reductions occurred in neurosurgical operations, clinic visits, and inpatient consultations during COVID-19. Telehealth was increasingly used for assessments. The long-term effects of the reduced neurosurgical volume and increased telehealth usage on patient outcomes should be explored.
 COVID-19 Elective surgery Neurological surgery SARS-CoV-2 Telehealth Trauma

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