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Impact of COVID-19 on a Neurosurgical Service: Lessons from the University of California San Diego.
World Neurosurg. 2021 04; 148:e172-e181.WN

Abstract

BACKGROUND

The institution-wide response of the University of California San Diego Health system to the 2019 novel coronavirus disease (COVID-19) pandemic was founded on rapid development of in-house testing capacity, optimization of personal protective equipment usage, expansion of intensive care unit capacity, development of analytic dashboards for monitoring of institutional status, and implementation of an operating room (OR) triage plan that postponed nonessential/elective procedures. We analyzed the impact of this triage plan on the only academic neurosurgery center in San Diego County, California, USA.

METHODS

We conducted a de-identified retrospective review of all operative cases and procedures performed by the Department of Neurosurgery from November 24, 2019, through July 6, 2020, a 226-day period. Statistical analysis involved 2-sample z tests assessing daily case totals over the 113-day periods before and after implementation of the OR triage plan on March 16, 2020.

RESULTS

The neurosurgical service performed 1429 surgical and interventional radiologic procedures over the study period. There was no statistically significant difference in mean number of daily total cases in the pre-versus post-OR triage plan periods (6.9 vs. 5.8 mean daily cases; 1-tail P = 0.050, 2-tail P = 0.101), a trend reflected by nearly every category of neurosurgical cases.

CONCLUSIONS

During the COVID-19 pandemic, the University of California San Diego Department of Neurosurgery maintained an operative volume that was only modestly diminished and continued to meet the essential neurosurgical needs of a large population. Lessons from our experience can guide other departments as they triage neurosurgical cases to meet community needs.

Authors+Show Affiliations

Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.Department of Neurosurgery, University of California San Diego, La Jolla, California, USA. Electronic address: bryba@health.ucsd.edu.Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.Department of Biomedical Informatics, University of California San Diego, La Jolla, California, USA.Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33385598

Citation

Wali, Arvin R., et al. "Impact of COVID-19 On a Neurosurgical Service: Lessons From the University of California San Diego." World Neurosurgery, vol. 148, 2021, pp. e172-e181.
Wali AR, Ryba BE, Kang K, et al. Impact of COVID-19 on a Neurosurgical Service: Lessons from the University of California San Diego. World Neurosurg. 2021;148:e172-e181.
Wali, A. R., Ryba, B. E., Kang, K., Santiago-Dieppa, D. R., Steinberg, J., Diaz-Aguilar, L. D., Stone, L. E., Brandel, M. G., Longhurst, C. A., Taylor, W., & Khalessi, A. A. (2021). Impact of COVID-19 on a Neurosurgical Service: Lessons from the University of California San Diego. World Neurosurgery, 148, e172-e181. https://doi.org/10.1016/j.wneu.2020.12.103
Wali AR, et al. Impact of COVID-19 On a Neurosurgical Service: Lessons From the University of California San Diego. World Neurosurg. 2021;148:e172-e181. PubMed PMID: 33385598.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of COVID-19 on a Neurosurgical Service: Lessons from the University of California San Diego. AU - Wali,Arvin R, AU - Ryba,Bryan E, AU - Kang,Keiko, AU - Santiago-Dieppa,David R, AU - Steinberg,Jeffrey, AU - Diaz-Aguilar,Luis Daniel, AU - Stone,Lauren E, AU - Brandel,Michael G, AU - Longhurst,Christopher A, AU - Taylor,William, AU - Khalessi,Alexander A, Y1 - 2020/12/30/ PY - 2020/09/26/received PY - 2020/12/17/revised PY - 2020/12/18/accepted PY - 2021/1/2/pubmed PY - 2021/4/10/medline PY - 2021/1/1/entrez KW - COVID-19 KW - Elective KW - Essential KW - Operative volume SP - e172 EP - e181 JF - World neurosurgery JO - World Neurosurg VL - 148 N2 - BACKGROUND: The institution-wide response of the University of California San Diego Health system to the 2019 novel coronavirus disease (COVID-19) pandemic was founded on rapid development of in-house testing capacity, optimization of personal protective equipment usage, expansion of intensive care unit capacity, development of analytic dashboards for monitoring of institutional status, and implementation of an operating room (OR) triage plan that postponed nonessential/elective procedures. We analyzed the impact of this triage plan on the only academic neurosurgery center in San Diego County, California, USA. METHODS: We conducted a de-identified retrospective review of all operative cases and procedures performed by the Department of Neurosurgery from November 24, 2019, through July 6, 2020, a 226-day period. Statistical analysis involved 2-sample z tests assessing daily case totals over the 113-day periods before and after implementation of the OR triage plan on March 16, 2020. RESULTS: The neurosurgical service performed 1429 surgical and interventional radiologic procedures over the study period. There was no statistically significant difference in mean number of daily total cases in the pre-versus post-OR triage plan periods (6.9 vs. 5.8 mean daily cases; 1-tail P = 0.050, 2-tail P = 0.101), a trend reflected by nearly every category of neurosurgical cases. CONCLUSIONS: During the COVID-19 pandemic, the University of California San Diego Department of Neurosurgery maintained an operative volume that was only modestly diminished and continued to meet the essential neurosurgical needs of a large population. Lessons from our experience can guide other departments as they triage neurosurgical cases to meet community needs. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/33385598/Impact_of_COVID_19_on_a_Neurosurgical_Service:_Lessons_from_the_University_of_California_San_Diego_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(20)32670-X DB - PRIME DP - Unbound Medicine ER -