Department of Neurosurgery, University of South Florida Morsani College of Medicine, Tampa General Hospital, Tampa, Florida, USA.
Department of Neurosurgery, Johns Hopkins University School of Medicine, Institute for Brain Protection Sciences, Johns Hopkins All Children's Hospital, Saint Petersburg, Florida, USA.
World Neurosurg. 2020 Oct;142:e481-e486. doi: 10.1016/j.wneu.2020.07.083. Epub 2020 Jul 19.
Every aspect of the medical field has been heavily affected by the coronavirus disease 2019 (COVID-19) pandemic, and neurosurgical services are no exception. Several departments have reported their experiences and protocols to provide insights for others impacted. The goals of this study are to report the load and variety of neurosurgical cases and clinic visits after discontinuing the COVID-19 Battle Plan at an academic tertiary care referral center to provide insights for other departments going through the same transition.
The clinical data of all patients who underwent a neurosurgical intervention between May 4, 2020, and June 4, 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 and clinic visits performed by the same neurosurgical service before the COVID-19 pandemic started.
One hundred sixty-one patients underwent neurosurgical interventions, and seven-hundred one patients were seen in clinic appointments, in the 4-week period following easing back from our COVID-19 "Battle Plan." Discontinuing the "Battle Plan" resulted in increases in case load to above-average practice after a week but a continued decrease in clinic appointments throughout the 4 weeks compared with average practice.
As policy-shaping crises like pandemics abate, easing back to "typical" practice can be completed effectively by appropriately allocating resources. This can be accomplished by anticipating increases in neurosurgical volume, specifically in the functional/epilepsy and brain tumor subspecialties, as well as continued decreases in neurosurgical clinic volume, specifically in elective spine.
2019 年冠状病毒病（COVID-19）大流行对医学领域的各个方面都产生了重大影响，神经外科服务也不例外。一些科室已经报告了他们的经验和方案，为其他受影响的科室提供了一些见解。本研究的目的是报告在学术性三级转诊中心停止 COVID-19“作战计划”后，神经外科病例和门诊就诊的数量和种类，为其他正在经历同样过渡的科室提供一些见解。
从一个前瞻性维护的数据库中获得了 2020 年 5 月 4 日至 2020 年 6 月 4 日期间接受神经外科干预的所有患者的临床数据。对照组的数据从病历中回顾性收集，以比较在 COVID-19 大流行开始之前，同一神经外科服务进行的手术/干预类型和门诊就诊。
在放宽 COVID-19“作战计划”后的 4 周内，有 161 名患者接受了神经外科干预，有 701 名患者接受了门诊预约。停止“作战计划”后，一周后病例量增加到高于平均水平，但与平均水平相比，整个 4 周内门诊就诊量持续下降。
随着像大流行这样的政策制定危机的消退，可以通过适当分配资源有效地恢复到“典型”实践。这可以通过预测神经外科工作量的增加来实现，特别是在功能/癫痫和脑肿瘤亚专科领域，以及神经外科门诊工作量的持续减少，特别是在择期脊柱领域。
