Department of Neurosurgery, Gold Coast University Hospital, Gold Coast, Australia; School of Medicine, The University of Queensland, Brisbane, Australia.
Department of Neurosurgery, Gold Coast University Hospital, Gold Coast, Australia.
World Neurosurg. 2020 Jul;139:e864-e871. doi: 10.1016/j.wneu.2020.05.136. Epub 2020 May 22.
This study was designed to assess the impact of public health policy in Australia in response to the coronavirus disease identified in 2019 (COVID-19) pandemic on the delivery of neurosurgical services. Being essential services, we postulated that there would not be a decrease in elective and emergency neurosurgical presentations and surgeries.
This is a prospective, observational, epidemiologic study in strict adherence to the "STROBE" (Strengthening The Reporting of OBservational studies in Epidemiology) guidelines. It is a cross-sectional, multicentric study involving 5 tertiary neurosurgical centers to capture all public neurosurgical admissions in Queensland during the past 3 months (February-April, 2020) of significant public health policy changes to combat COVID-19.
An analysis of the 1298 admissions for the Queensland population of 5.07 million Australians demonstrated a decrease in the number of elective and emergency admissions. The decline in elective admissions, particularly degenerative spine, benign neoplasms, and vascular pathologies, was a direct response of government strategy to curb activity to urgent surgical interventions only. Moreover, a trend toward fewer emergency admissions was also noted, partly explained by less trauma and also a decline in vascular pathologies including subarachnoid hemorrhage.
In comparison with Europe and North America, this study demonstrates the impact of proactive public health measures in Australia that successfully flattened the COVID-19 curve while facilitating ongoing care of acutely unwell neurosurgical patients.
本研究旨在评估澳大利亚应对 2019 年（COVID-19）大流行所采取的公共卫生政策对神经外科服务提供的影响。神经外科属于基本医疗服务，我们推测，择期和急诊神经外科手术不会减少。
这是一项前瞻性、观察性、流行病学研究，严格遵循“STROBE”（加强观察性研究报告的流行病学）指南。这是一项涉及 5 个三级神经外科中心的横断面、多中心研究，旨在捕获昆士兰州在过去 3 个月（2020 年 2 月至 4 月）内所有公共神经外科入院情况，这是应对 COVID-19 的重大公共卫生政策变化时期。
对昆士兰州 507 万澳大利亚人口的 1298 例入院进行分析显示，择期和急诊入院人数减少。退行性脊柱、良性肿瘤和血管病变等择期手术的减少，是政府遏制活动、仅进行紧急手术干预策略的直接反应。此外，急诊入院人数也呈下降趋势，这在一定程度上是由于创伤减少，以及包括蛛网膜下腔出血在内的血管病变减少所致。
与欧洲和北美相比，本研究表明，澳大利亚积极主动的公共卫生措施产生了影响，成功地减缓了 COVID-19 的传播，同时为急性不适的神经外科患者提供了持续的治疗。
