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Neurosurgical Procedures and Safety During the COVID-19 Pandemic: A Case-Control Multicenter Study.
World Neurosurg. 2020 11; 143:e179-e187.WN

Abstract

OBJECTIVE

Quantitative documentation of the effects of outbreaks, including the coronavirus disease 2019 (COVID-19) pandemic, is limited in neurosurgery. Our study aimed to evaluate the effects of the COVID-19 pandemic on neurosurgical practice and to determine whether surgical procedures are associated with increased morbidity and mortality.

METHODS

A multicenter case-control study was conducted, involving patients who underwent neurosurgical intervention in the Kingdom of Saudi Arabia during 2 periods: pre-COVID-19 and during the COVID-19 pandemic. The surgical intervention data evaluated included diagnostic category, case priority, complications, length of hospital stay, and 30-day mortality.

RESULTS

A total of 850 procedures were included, 36% during COVID-19. The median number of procedures per day was significantly lower during the COVID-19 period (5.5 cases) than during the pre-COVID-19 period (12 cases; P < 0.0001). Complications, length of hospital stay, and 30-day mortality did not differ during the pandemic. In a multivariate analysis comparing both periods, case priority levels 1 (immediate) (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.24-2.67), 1 (1-24 h) (OR, 1.63; 95% CI, 1.10-2.41), and 4 (OR, 0.28; 95% CI, 0.19-0.42) showed significant differences.

CONCLUSIONS

During the early phase of the COVID-19 pandemic, the overall number of neurosurgical procedures declined, but the load of emergency procedures remained the same, thus highlighting the need to allocate sufficient resources for emergencies. More importantly, performing neurosurgical procedures during the pandemic in regions with limited effects of the outbreak on the health care system was safe. Our findings may aid in developing guidelines for acute and long-term care during pandemics in surgical subspecialties.

Authors+Show Affiliations

Department of Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia; Department of Neurology and Neurosurgery, Montreal Neurological Institute and hospital, McGill University, Montreal, Quebec, Canada.Neurosurgery Division, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.Neurosurgery Division, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.Department of Adult Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia.Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.Division of Neurosurgery, Department of Surgery, Specialized Medical Center, Riyadh, Saudi Arabia.Division of Neurosurgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia.Department of Neurosurgery, King Saud Medical City, Riyadh, Saudi Arabia.Vascular Endovascular and Skull Base Neurosurgery, College of Medicine, Taibah University, Madinah, Saudi Arabia.Department of Pediatric Neurosurgery, National Neuroscience institute, King Fahad Medical City, Riyadh, Saudi Arabia.Department of Neurosurgery, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.Department of Neuroscience, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.Department of Neurology and Neurosurgery, Montreal Neurological Institute and hospital, McGill University, Montreal, Quebec, Canada; Department of Neurosurgery, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.Department of Spine Surgery, Dr Sulaiman Alhabib Hospital, Khobar, Saudi Arabia.Division of Neurosurgery, Department of Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia.Division of Neurosurgery, Department of Surgery, King Khalid University Hospital, Riyadh, Saudi Arabia.Department of Neurosurgery, International Medical Center, Jeddah, Saudi Arabia.Department of Neurosurgery, King Fahad specialist Hospital, Dammam, Saudi Arabia.Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.Department of Adult Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia.Neurosciences Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.Division of Neurosurgery, Department of Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia.Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.Neurosurgery Division, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.Department of Neurosurgery, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia.Department of Neurosurgery, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.Neurosurgery Division, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.Neurosurgery Division, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia. Electronic address: abdajlan@ksu.edu.sa.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

32702490

Citation

Bajunaid, Khalid, et al. "Neurosurgical Procedures and Safety During the COVID-19 Pandemic: a Case-Control Multicenter Study." World Neurosurgery, vol. 143, 2020, pp. e179-e187.
Bajunaid K, Alqurashi A, Alatar A, et al. Neurosurgical Procedures and Safety During the COVID-19 Pandemic: A Case-Control Multicenter Study. World Neurosurg. 2020;143:e179-e187.
Bajunaid, K., Alqurashi, A., Alatar, A., Alkutbi, M., Alzahrani, A. H., Sabbagh, A. J., Alobaid, A., Barnawi, A., Alferayan, A. A., Alkhani, A. M., Salamah, A. B., Sheikh, B. Y., Alotaibi, F. E., Alabbas, F., Farrash, F., Al-Jehani, H. M., Alhabib, H., Alnaami, I., Altweijri, I., ... Ajlan, A. (2020). Neurosurgical Procedures and Safety During the COVID-19 Pandemic: A Case-Control Multicenter Study. World Neurosurgery, 143, e179-e187. https://doi.org/10.1016/j.wneu.2020.07.093
Bajunaid K, et al. Neurosurgical Procedures and Safety During the COVID-19 Pandemic: a Case-Control Multicenter Study. World Neurosurg. 2020;143:e179-e187. PubMed PMID: 32702490.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neurosurgical Procedures and Safety During the COVID-19 Pandemic: A Case-Control Multicenter Study. AU - Bajunaid,Khalid, AU - Alqurashi,Ashwag, AU - Alatar,Abdullah, AU - Alkutbi,Mohammad, AU - Alzahrani,Anas H, AU - Sabbagh,Abdulrahman J, AU - Alobaid,Abdullah, AU - Barnawi,Abdulwahed, AU - Alferayan,Ahmed Abdulrahman, AU - Alkhani,Ahmed M, AU - Salamah,Ali Bin, AU - Sheikh,Bassem Yousef, AU - Alotaibi,Fahad E, AU - Alabbas,Faisal, AU - Farrash,Faisal, AU - Al-Jehani,Hosam M, AU - Alhabib,Husam, AU - Alnaami,Ibrahim, AU - Altweijri,Ikhlass, AU - Khoja,Isam, AU - Taha,Mahmoud, AU - Alzahrani,Moajeb, AU - Bafaquh,Mohammed S, AU - Binmahfoodh,Mohammed, AU - Algahtany,Mubarak Ali, AU - Al-Rashed,Sabah, AU - Raza,Syed Muhammad, AU - Elwatidy,Sherif, AU - Alomar,Soha A, AU - Al-Issawi,Wisam, AU - Khormi,Yahya H, AU - Ammar,Ahmad, AU - Al-Habib,Amro, AU - Baeesa,Saleh S, AU - Ajlan,Abdulrazag, Y1 - 2020/07/20/ PY - 2020/07/12/received PY - 2020/07/14/accepted PY - 2020/7/24/pubmed PY - 2020/12/15/medline PY - 2020/7/24/entrez KW - COVID-19 KW - Neurosurgery KW - Pandemic KW - Surgical outcome KW - Triage SP - e179 EP - e187 JF - World neurosurgery JO - World Neurosurg VL - 143 N2 - OBJECTIVE: Quantitative documentation of the effects of outbreaks, including the coronavirus disease 2019 (COVID-19) pandemic, is limited in neurosurgery. Our study aimed to evaluate the effects of the COVID-19 pandemic on neurosurgical practice and to determine whether surgical procedures are associated with increased morbidity and mortality. METHODS: A multicenter case-control study was conducted, involving patients who underwent neurosurgical intervention in the Kingdom of Saudi Arabia during 2 periods: pre-COVID-19 and during the COVID-19 pandemic. The surgical intervention data evaluated included diagnostic category, case priority, complications, length of hospital stay, and 30-day mortality. RESULTS: A total of 850 procedures were included, 36% during COVID-19. The median number of procedures per day was significantly lower during the COVID-19 period (5.5 cases) than during the pre-COVID-19 period (12 cases; P < 0.0001). Complications, length of hospital stay, and 30-day mortality did not differ during the pandemic. In a multivariate analysis comparing both periods, case priority levels 1 (immediate) (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.24-2.67), 1 (1-24 h) (OR, 1.63; 95% CI, 1.10-2.41), and 4 (OR, 0.28; 95% CI, 0.19-0.42) showed significant differences. CONCLUSIONS: During the early phase of the COVID-19 pandemic, the overall number of neurosurgical procedures declined, but the load of emergency procedures remained the same, thus highlighting the need to allocate sufficient resources for emergencies. More importantly, performing neurosurgical procedures during the pandemic in regions with limited effects of the outbreak on the health care system was safe. Our findings may aid in developing guidelines for acute and long-term care during pandemics in surgical subspecialties. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/32702490/Neurosurgical_Procedures_and_Safety_During_the_COVID_19_Pandemic:_A_Case_Control_Multicenter_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(20)31614-4 DB - PRIME DP - Unbound Medicine ER -