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新冠疫情对新奥尔良两家学术神经外科中心手术量和住院医师培训的影响。

Effects of the COVID-19 Pandemic on Operative Volume and Residency Training at Two Academic Neurosurgery Centers in New Orleans.

机构信息

Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA.

Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA.

出版信息

World Neurosurg. 2021 Jul;151:e68-e77. doi: 10.1016/j.wneu.2021.03.122. Epub 2021 Mar 31.

Abstract

BACKGROUND

Medical subspecialties including neurosurgery have seen a dramatic shift in operative volume in the wake of the coronavirus disease 2019 (COVID-19) pandemic. The goal of this study was to quantify the effects of the COVID-19 pandemic on operative volume at 2 academic neurosurgery centers in New Orleans, Louisiana, USA from equivalent periods before and during the COVID-19 pandemic.

METHODS

A retrospective review was conducted analyzing neurosurgical case records for 2 tertiary academic centers from March to June 2020 and March to June 2019. The records were reviewed for variables including institution and physician coverage, operative volume by month and year, cases per subspecialty, patient demographics, mortality, and morbidity.

RESULTS

Comparison of groups showed a 34% reduction in monthly neurosurgical volume per institution during the pandemic compared with earlier time points, including a 77% decrease during April 2020. There was no change in mortality and morbidity across institutions during the pandemic.

CONCLUSIONS

The COVID-19 pandemic has had a significant impact on neurosurgical practice and will likely continue to have long-term effects on patients at a time when global gross domestic products decrease and relative health expenditures increase. Clinicians must anticipate and actively prepare for these impacts in the future.

摘要

背景

在 2019 年冠状病毒病(COVID-19)大流行之后,包括神经外科在内的医学亚专业的手术量发生了巨大变化。本研究的目的是量化 COVID-19 大流行对美国路易斯安那州新奥尔良市 2 个学术神经外科中心手术量的影响,比较 COVID-19 大流行前后的同期数据。

方法

对 2020 年 3 月至 6 月和 2019 年 3 月至 6 月期间的 2 个三级学术中心的神经外科病例记录进行回顾性分析。对包括机构和医生覆盖范围、每月和每年的手术量、每个亚专业的病例数、患者人口统计学、死亡率和发病率在内的变量进行了审查。

结果

与早期相比,疫情期间每个机构的每月神经外科手术量减少了 34%,其中 2020 年 4 月下降了 77%。在疫情期间,各机构的死亡率和发病率没有变化。

结论

COVID-19 大流行对神经外科实践产生了重大影响,并且可能会在全球国内生产总值下降和相对卫生支出增加的情况下,对患者产生长期影响。临床医生必须在未来预期并积极准备应对这些影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c72c/9760312/c3c854de1ac5/gr1_lrg.jpg

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