Department of Neurosurgery, Johns Hopkins University School of Medicine, Institute for Brain Protection Sciences, Johns Hopkins All Children's Hospital, St. Petersburg, USA.
Department of Neurosurgery, University of South Florida Morsani College of Medicine, Tampa General Hospital, Tampa, Florida, USA.
World Neurosurg. 2020 Jul;139:e872-e876. doi: 10.1016/j.wneu.2020.05.150. Epub 2020 May 23.
Neurosurgical services have been affected by the 2019 novel coronavirus disease (COVID-19) pandemic, and several departments have reported their experiences and responses to the COVID-19 crisis in an attempt to provide insights from which other impacted departments can benefit. The goals of this study were to report the load and variety of emergent/urgent neurosurgical cases after implementing the "Battle Plan" at an academic tertiary referral center during the COVID-19 pandemic and to compare these variables with previous practice at the same institution.
The clinical data of all patients who underwent a neurosurgical intervention between March 23, 2020, and April 20, 2020, were obtained from a prospectively maintained database. Data of the control group were retrospectively collected from the medical records to compare the types of surgeries/interventions performed by the same neurosurgical service before the COVID-19 pandemic started.
Over a 4-week period during the COVID-19 pandemic, 91 patients underwent emergent, urgent, and essential neurosurgical interventions. Patient screening at teleclinics identified 11 urgent surgical cases. The implementation of the Battle Plan led to a significant decrease in the caseload, and the variation of cases by subspecialty was evident when compared with a control group comprising 214 patients.
Delivery of optimal care and safe practice and education at an academic neurosurgical department can be well maintained with proper execution of crisis protocols. Teleclinics proved to be efficient in screening patients for urgent neurosurgical conditions, but in-person clinic visits may still be necessary for some cases in the immediate postoperative period.
神经外科服务受到 2019 年新型冠状病毒病（COVID-19）大流行的影响，许多科室都报告了他们在应对 COVID-19 危机方面的经验和应对措施，试图从中获得其他受影响科室可以受益的见解。本研究的目的是报告在学术型三级转诊中心实施“作战计划”后 COVID-19 大流行期间紧急/紧急神经外科病例的数量和种类，并将这些变量与同一机构之前的实践进行比较。
从一个前瞻性维护的数据库中获得了 2020 年 3 月 23 日至 2020 年 4 月 20 日期间接受神经外科干预的所有患者的临床数据。对照组的数据通过病历回顾收集，以比较 COVID-19 大流行开始前同一神经外科服务所进行的手术/干预类型。
在 COVID-19 大流行期间的 4 周内，91 例患者接受了紧急、紧急和必要的神经外科干预。远程诊所的患者筛查确定了 11 例紧急手术病例。作战计划的实施导致病例量显著减少，与包括 214 例患者的对照组相比，各亚专业的病例变化明显。
在学术神经外科部门，通过正确执行危机方案，可以很好地维持提供最佳护理和安全实践和教育。远程诊所已被证明可有效地对紧急神经外科情况进行患者筛查，但在某些情况下仍需要进行门诊访视。
