National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland.
Royal College of Surgeons in Ireland, Dublin, Ireland.
Ir J Med Sci. 2021 Aug;190(3):905-911. doi: 10.1007/s11845-020-02429-7. Epub 2020 Nov 5.
The COVID-19 pandemic has resulted in a significant disruption in the provision of healthcare globally. The aim of this study was to assess the implications of the COVID-19 pandemic on the provision of neuro-oncology surgery and comparison with a similar 3-month period in 2019.
Retrospective review of prospectively curated database of patients requiring neuro-oncology surgery at our tertiary referral centre between 1st March 2020 and 31st May 2020. We also analysed data for the same time period (1st March-31st May) in 2019 for comparison. Number and type of tumours operated on, postoperative morbidity and mortality, COVID-19-related complications and delays in treatment were recorded.
During the 3-month periods studied in 2020 and 2019, there were 127 and 139 admissions for neuro-oncological surgery, respectively. Sixty patients underwent surgery for gliomas during the 2020 period vs 56 in the 2019 period. We observed no increase in mean length of time from referral to inter-hospital transfer (mean of 76 h in 2020 vs 93 h in 2019 (p = 0.10)) or in mean length of time from admission to surgery in the acute admissions (2.39 days in 2020 vs 2.89 days in 2019). The postoperative 30-day morbidity and mortality rates were lower in 2020; 8.7% (n = 11) compared with 10.1% (n = 14) in 2019. There was one COVID-19-related death which occurred in a patient with B cell lymphoma with negative preoperative COVID-19 test.
The provision of neuro-oncological surgery can be safely continued during respiratory illness epidemic or pandemic if a rigorous testing and staffing framework is implemented.
COVID-19 大流行在全球范围内对医疗保健的提供造成了重大干扰。本研究的目的是评估 COVID-19 大流行对神经肿瘤外科手术提供的影响,并与 2019 年同期的类似 3 个月进行比较。
回顾性分析我们的三级转诊中心在 2020 年 3 月 1 日至 5 月 31 日期间需要神经肿瘤外科手术的患者的前瞻性数据库。我们还分析了 2019 年同期(3 月 1 日至 5 月 31 日)的数据进行比较。记录手术的肿瘤数量和类型、术后发病率和死亡率、与 COVID-19 相关的并发症和治疗延迟。
在 2020 年和 2019 年研究的 3 个月期间,分别有 127 例和 139 例患者入院接受神经肿瘤外科手术。2020 年期间有 60 例患者因脑胶质瘤接受手术,而 2019 年为 56 例。我们没有观察到从转诊到医院间转移的平均时间(2020 年为 76 小时,2019 年为 93 小时(p=0.10))或从入院到急性入院手术的平均时间增加(2020 年为 2.39 天,2019 年为 2.89 天)。2020 年术后 30 天发病率和死亡率较低;8.7%(n=11),而 2019 年为 10.1%(n=14)。有一例与 COVID-19 相关的死亡,发生在一名术前 COVID-19 检测呈阴性的 B 细胞淋巴瘤患者中。
如果实施严格的检测和人员配备框架,在呼吸道疾病流行或大流行期间可以安全地继续提供神经肿瘤外科手术。