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The longitudinal impact of COVID-19 pandemic on neurosurgical practice.
Clin Neurol Neurosurg. 2020 11; 198:106237.CN

Abstract

OBJECTIVE

This observational cross-sectional multicenter study aimed to evaluate the longitudinal impact of the coronavirus disease 2019 (COVID-19) pandemic on neurosurgical practice.

METHODS

We included 29 participating neurosurgeons in centers from all geographical regions in the Kingdom of Saudi Arabia. The study period, which was between March 5, 2020 and May 20, 2020, was divided into three equal periods to determine the longitudinal effect of COVID-19 measures on neurosurgical practice over time.

RESULTS

During the 11-week study period, 474 neurosurgical interventions were performed. The median number of neurosurgical procedures per day was 5.5 (interquartile range [IQR]: 3.5-8). The number of cases declined from 72 in the first week and plateaued at the 30's range in subsequent weeks. The most and least number of performed procedures were oncology (129 [27.2 %]) and functional procedures (6 [1.3 %]), respectively. Emergency (Priority 1) cases were more frequent than non-urgent (Priority 4) cases (178 [37.6 %] vs. 74 [15.6 %], respectively). In our series, there were three positive COVID-19 cases. There was a significant among-period difference in the length of hospital stay, which dropped from a median stay of 7 days (IQR: 4-18) to 6 (IQR: 3-13) to 5 days (IQR: 2-8). There was no significant among-period difference with respect to institution type, complications, or mortality.

CONCLUSION

Our study demonstrated that the COVID-19 pandemic decreased the number of procedures performed in neurosurgery practice. The load of emergency neurosurgery procedures did not change throughout the three periods, which reflects the need to designate ample resources to cover emergencies. Notably, with strict screening for COVID -19 infections, neurosurgical procedures could be safely performed during the early pandemic phase. We recommend to restart performing neurosurgical procedures once the pandemic gets stabilized to avoid possible post pandemic health-care system intolerable overload.

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
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33002677

Citation

Bajunaid, Khalid, et al. "The Longitudinal Impact of COVID-19 Pandemic On Neurosurgical Practice." Clinical Neurology and Neurosurgery, vol. 198, 2020, p. 106237.
Bajunaid K, Alatar A, Alqurashi A, et al. The longitudinal impact of COVID-19 pandemic on neurosurgical practice. Clin Neurol Neurosurg. 2020;198:106237.
Bajunaid, K., Alatar, A., Alqurashi, A., Alkutbi, M., Alzahrani, A. H., Sabbagh, A. J., Alobaid, A., Barnawi, A., Alferayan, A. A., Alkhani, A. M., Bin Salamah, A., Sheikh, B. Y., Alotaibi, F. E., Alabbas, F., Farrash, F., Al-Jehani, H. M., Alhabib, H., Alnaami, I., Altweijri, I., ... Ajlan, A. (2020). The longitudinal impact of COVID-19 pandemic on neurosurgical practice. Clinical Neurology and Neurosurgery, 198, 106237. https://doi.org/10.1016/j.clineuro.2020.106237
Bajunaid K, et al. The Longitudinal Impact of COVID-19 Pandemic On Neurosurgical Practice. Clin Neurol Neurosurg. 2020;198:106237. PubMed PMID: 33002677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The longitudinal impact of COVID-19 pandemic on neurosurgical practice. AU - Bajunaid,Khalid, AU - Alatar,Abdullah, AU - Alqurashi,Ashwag, AU - Alkutbi,Mohammad, AU - Alzahrani,Anas H, AU - Sabbagh,Abdulrahman J, AU - Alobaid,Abdullah, AU - Barnawi,Abdulwahed, AU - Alferayan,Ahmed A, AU - Alkhani,Ahmed M, AU - Bin Salamah,Ali, AU - Sheikh,Bassem Y, 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 A, AU - Al-Rashed,Sabah, AU - Raza,Syed M, 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 - 2020/09/17/ PY - 2020/07/17/received PY - 2020/08/21/revised PY - 2020/09/12/accepted PY - 2020/10/2/pubmed PY - 2020/11/27/medline PY - 2020/10/1/entrez KW - COVID-19 KW - Impact KW - Neurosurgery KW - Neurosurgical practice KW - Pandemic SP - 106237 EP - 106237 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 198 N2 - OBJECTIVE: This observational cross-sectional multicenter study aimed to evaluate the longitudinal impact of the coronavirus disease 2019 (COVID-19) pandemic on neurosurgical practice. METHODS: We included 29 participating neurosurgeons in centers from all geographical regions in the Kingdom of Saudi Arabia. The study period, which was between March 5, 2020 and May 20, 2020, was divided into three equal periods to determine the longitudinal effect of COVID-19 measures on neurosurgical practice over time. RESULTS: During the 11-week study period, 474 neurosurgical interventions were performed. The median number of neurosurgical procedures per day was 5.5 (interquartile range [IQR]: 3.5-8). The number of cases declined from 72 in the first week and plateaued at the 30's range in subsequent weeks. The most and least number of performed procedures were oncology (129 [27.2 %]) and functional procedures (6 [1.3 %]), respectively. Emergency (Priority 1) cases were more frequent than non-urgent (Priority 4) cases (178 [37.6 %] vs. 74 [15.6 %], respectively). In our series, there were three positive COVID-19 cases. There was a significant among-period difference in the length of hospital stay, which dropped from a median stay of 7 days (IQR: 4-18) to 6 (IQR: 3-13) to 5 days (IQR: 2-8). There was no significant among-period difference with respect to institution type, complications, or mortality. CONCLUSION: Our study demonstrated that the COVID-19 pandemic decreased the number of procedures performed in neurosurgery practice. The load of emergency neurosurgery procedures did not change throughout the three periods, which reflects the need to designate ample resources to cover emergencies. Notably, with strict screening for COVID -19 infections, neurosurgical procedures could be safely performed during the early pandemic phase. We recommend to restart performing neurosurgical procedures once the pandemic gets stabilized to avoid possible post pandemic health-care system intolerable overload. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/33002677/The_longitudinal_impact_of_COVID_19_pandemic_on_neurosurgical_practice_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(20)30580-1 DB - PRIME DP - Unbound Medicine ER -