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COVID-19 大流行避难期间分流手术数量意外减少。

Unexpected Decrease in Shunt Surgeries Performed during the Shelter-in-Place Period of the COVID-19 Pandemic.

机构信息

Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, United States of America.

Pediatric Neurosurgery Associates, Children's Healthcare of Atlanta, Atlanta, Georgia, United States of America.

出版信息

Oper Neurosurg (Hagerstown). 2021 Apr 15;20(5):469-476. doi: 10.1093/ons/opaa461.

Abstract

BACKGROUND

It is expected that the incidence of cerebrospinal fluid (CSF) shunt malfunctions would remain unchanged during the shelter-in-place period related to the COVID-19 pandemic.

OBJECTIVE

To examine the number of shunt surgeries performed in a single institution during this time interval in comparison to equivalent periods in past years.

METHODS

The numbers of elective and emergent/urgent shunt surgeries performed at a single institution were queried for a 28-d period starting on the third Monday of March, between years 2015 and 2020. These were further stratified by how they presented as well as the type of surgery performed.

RESULTS

During the 28-d period of interest, in the years between 2015 and 2020, there was a steady increase in the number of shunt surgeries performed, with a maximum of 64 shunt surgeries performed in 2019. Of these, approximately 50% presented in urgent fashion in any given year. In the 4-wk period starting March 16, 2020, a total of 32 shunt surgeries were performed, with 15 of those cases presenting from the outpatient setting in emergent/urgent fashion. For the surgeries performed, there was a statistically significant decrease in the number of revision shunt surgeries performed.

CONCLUSION

During the 2020 COVID-19 pandemic, there was an unexpected decrease in the number of shunt surgeries performed, and particularly in the number of revision surgeries performed. This suggests that an environmental factor related to the pandemic is altering the presentation rate of shunt malfunctions.

摘要

背景

预计与 COVID-19 大流行相关的就地避难期间,脑脊液(CSF)分流器故障的发生率将保持不变。

目的

在此期间,检查在单家机构中进行的分流手术数量与过去几年同期相比的变化。

方法

在 2015 年至 2020 年期间,对一家机构在 3 月的第三个星期一开始的 28 天内进行的择期和紧急/紧急分流手术数量进行了查询。根据手术的表现和手术类型对这些手术进一步分层。

结果

在 28 天的研究期间,在 2015 年至 2020 年期间,进行分流手术的数量稳步增加,2019 年进行了最多 64 次分流手术。其中,每年约有 50%的患者以紧急方式就诊。在 2020 年 3 月 16 日开始的 4 周期间,共进行了 32 次分流手术,其中 15 例从门诊以紧急/紧急方式就诊。对于进行的手术,有统计学意义的是,进行的翻修分流手术数量减少。

结论

在 2020 年 COVID-19 大流行期间,进行的分流手术数量,特别是翻修手术数量出乎意料地减少。这表明与大流行有关的环境因素正在改变分流器故障的表现率。

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