Gerlach Ruediger, Dengler Julius, Bollmann Andreas, Stoffel Michael, Youssef Farid, Carl Barbara, Rosahl Steffen, Ryang Yu-Mi, Terzis Jorge, Kristof Rudolf, Westermaier Thomas, Kuhlen Ralf, Steinbrecher Andreas, Pellissier Vincent, Hohenstein Sven, Heese Oliver
Department of Neurosurgery, HELIOS Klinikum Erfurt, Erfurt, Germany.
Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Campus Bad Saarow, Bad Saarow, Germany and Department of Neurosurgery, HELIOS Hospital Bad Saarow, Bad Saarow, Germany.
Neurooncol Pract. 2023 Mar 24;10(5):429-436. doi: 10.1093/nop/npad015. eCollection 2023 Oct.
Little is known about delivery of neurosurgical care, complication rate and outcome of patients with high-grade glioma (HGG) during the coronavirus disease 2019 (Covid-19) pandemic.
This observational, retrospective cohort study analyzed routine administrative data of all patients admitted for neurosurgical treatment of an HGG within the Helios Hospital network in Germany. Data of the Covid-19 pandemic (March 1, 2020-May 31, 2022) were compared to the pre-pandemic period (January 1, 2016-February 29, 2020). Frequency of treatment and outcome (in-hospital mortality, length of hospital stay [LOHS], time in intensive care unit [TICU] and ventilation outside the operating room [OR]) were separately analyzed for patients with microsurgical resection (MR) or stereotactic biopsy (STBx).
A total of 1763 patients underwent MR of an HGG (648 patients during the Covid-19 pandemic; 1115 patients in the pre-pandemic period). 513 patients underwent STBx (182 [pandemic]; 331 patients [pre-pandemic]). No significant differences were found for treatment frequency (MR: 2.95 patients/week [Covid-19 pandemic] vs. 3.04 patients/week [pre-pandemic], IRR 0.98, 95% CI: 0.89-1.07; STBx (1.82 [Covid-19 pandemic] vs. 1.86 [pre-pandemic], IRR 0.96, 95% CI: 0.80-1.16, > .05). Rates of in-hospital mortality, infection, postoperative hemorrhage, cerebral ischemia and ventilation outside the OR were similar in both periods. Overall LOHS was significantly shorter for patients with MR and STBx during the Covid-19 pandemic.
The Covid-19 pandemic did not affect the frequency of neurosurgical treatment of patients with an HGG based on data of a large nationwide hospital network in Germany. LOHS was significantly shorter but quality of neurosurgical care and outcome was not altered during the Covid-19 pandemic.
关于2019冠状病毒病（Covid-19）大流行期间高级别胶质瘤（HGG）患者的神经外科护理提供情况、并发症发生率和预后知之甚少。
这项观察性、回顾性队列研究分析了德国赫利俄斯医院网络内所有因HGG接受神经外科治疗的患者的常规管理数据。将Covid-19大流行期间（2020年3月1日至2022年5月31日）的数据与大流行前时期（2016年1月1日至2020年2月29日）的数据进行比较。分别分析了接受显微手术切除（MR）或立体定向活检（STBx）的患者的治疗频率和预后（住院死亡率、住院时间[LOHS]、重症监护病房时间[TICU]和手术室（OR）外通气时间）。
共有1763例患者接受了HGG的MR治疗（Covid-19大流行期间648例；大流行前时期1115例）。513例患者接受了STBx（大流行期间182例；大流行前331例）。治疗频率无显著差异（MR：2.95例/周[Covid-19大流行]对3.04例/周[大流行前]，IRR 0.98，95%CI：0.89-1.07；STBx：1.82例/周[Covid-19大流行]对1.86例/周[大流行前]，IRR 0.96，95%CI：0.80-1.16，P>0.05）。两个时期的住院死亡率、感染率、术后出血率、脑缺血率和OR外通气率相似。在Covid-19大流行期间，接受MR和STBx治疗的患者的总体LOHS显著缩短。
根据德国一个大型全国性医院网络的数据，Covid-19大流行并未影响HGG患者的神经外科治疗频率。在Covid-19大流行期间，LOHS显著缩短，但神经外科护理质量和预后未改变。
