Azab Mohammed A, Azzam Ahmed Y, Salem Ahmed E
Department of Neurosurgery, Cairo University Faculty of Medicine, Cairo, Egypt.
October 6 University Faculty of Medicine, Giza, Egypt.
Interdiscip Neurosurg. 2022 Mar;27:101416. doi: 10.1016/j.inat.2021.101416. Epub 2021 Oct 28.
Globally, there is a shooting pandemic that affected many healthcare systems. Healthcare facilities had to set up strategies to avoid exhaustion while facing a catastrophic health problem. Vaccines or perfect therapies were not available over a long pandemic time and also no certified immunity against that disease is guaranteed. Therefore, it is probable that healthcare systems will face it for an exceptionally long period. That already had a grave effect on the strategy of daily practice of different specialties' services at healthcare centers.
We tried simply to share a countryside hospital's expertise in managing neurosurgical cases amid a dreadful health crisis. Healthcare workers' safety and patient safety were typical priorities for neurosurgical service at Damietta Specialized Hospital. We expose the lines of management, triaging cases, the methods of handling confirmed and suspected neurosurgical patients, and strategies for discharging and following up patients. We identified hospital admission and discharge records starting from February 2020 till February 2021 to track the neurosurgical case burden, the state of service offered and the rate of infection among healthcare workers who participated in surgeries.
At the peak time of the COVID‑19 pandemic in Egypt starting from February 2020 till February 2021, we have admitted about 500 neurosurgical patients. About 400 (80%) of them did surgeries according to the triaging protocol of the hospital. About 150 (30%) of those who did surgeries were urgent and the rest were borderline or semi‑urgent. About 20 (4%) were tested COVID-19 positive and six of them died due to acute respiratory distress syndrome. Only two mortality cases were reported due to post-operative complications and not related to SARS‑CoV‑2 infection. The rest of the cases (97.6%) were discharged for follow‑up without complications. No neurosurgeons but three anesthesia staff were infected with SARS‑CoV‑2. A successful undisturbed neurosurgical care was available for patients during COVID-19 time.
Following the suggested strategies, a rural area-serving hospital managed to provide uninterrupted neurosurgical care amid COVID-19 pandemic in Egypt. Rural areas in developing countries are in need of strategies to deal with pandemics in the future without dismantling the normal health system, especially for life‑saving cases in a critical specialty as neurosurgery.
在全球范围内，一场大规模流行疾病影响了许多医疗系统。医疗机构不得不制定策略以避免在面对灾难性健康问题时出现疲惫不堪的状况。在漫长的疫情期间，疫苗或完美的治疗方法并不存在，而且也无法保证对该疾病有经过认证的免疫力。因此，医疗系统很可能会在异常长的时期内面临这一情况。这已经对医疗中心不同专科服务的日常实践策略产生了严重影响。
我们只是试图分享一家乡村医院在可怕的健康危机中管理神经外科病例的专业经验。在达米埃塔专科医院，医护人员的安全和患者的安全是神经外科服务的典型优先事项。我们阐述了管理流程、病例分诊、处理确诊和疑似神经外科患者的方法，以及患者出院和随访的策略。我们确定了从2020年2月到2021年2月的医院入院和出院记录，以追踪神经外科病例负担、所提供服务的状况以及参与手术的医护人员中的感染率。
在从2020年2月到2021年2月埃及新冠疫情的高峰期，我们收治了约500名神经外科患者。其中约400名（80%）根据医院的分诊方案接受了手术。接受手术的患者中约150名（30%）是紧急情况，其余为临界或半紧急情况。约20名（4%）新冠病毒检测呈阳性，其中6人因急性呼吸窘迫综合征死亡。仅报告了2例因术后并发症而非与SARS-CoV-2感染相关的死亡病例。其余病例（97.6%）出院进行随访，无并发症。没有神经外科医生感染SARS-CoV-2，但有三名麻醉工作人员感染。在新冠疫情期间，为患者提供了成功且未受干扰的神经外科护理。
遵循所建议的策略，一家为农村地区服务的医院在埃及新冠疫情期间成功提供了不间断的神经外科护理。发展中国家的农村地区未来需要在不破坏正常卫生系统的情况下应对大流行的策略，特别是对于神经外科等关键专科的救命病例。
