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World Neurosurg ; 148: e172-e181, 2021 04.
Artículo en Inglés | MEDLINE | ID: covidwho-1078227

RESUMEN

BACKGROUND: The institution-wide response of the University of California San Diego Health system to the 2019 novel coronavirus disease (COVID-19) pandemic was founded on rapid development of in-house testing capacity, optimization of personal protective equipment usage, expansion of intensive care unit capacity, development of analytic dashboards for monitoring of institutional status, and implementation of an operating room (OR) triage plan that postponed nonessential/elective procedures. We analyzed the impact of this triage plan on the only academic neurosurgery center in San Diego County, California, USA. METHODS: We conducted a de-identified retrospective review of all operative cases and procedures performed by the Department of Neurosurgery from November 24, 2019, through July 6, 2020, a 226-day period. Statistical analysis involved 2-sample z tests assessing daily case totals over the 113-day periods before and after implementation of the OR triage plan on March 16, 2020. RESULTS: The neurosurgical service performed 1429 surgical and interventional radiologic procedures over the study period. There was no statistically significant difference in mean number of daily total cases in the pre-versus post-OR triage plan periods (6.9 vs. 5.8 mean daily cases; 1-tail P = 0.050, 2-tail P = 0.101), a trend reflected by nearly every category of neurosurgical cases. CONCLUSIONS: During the COVID-19 pandemic, the University of California San Diego Department of Neurosurgery maintained an operative volume that was only modestly diminished and continued to meet the essential neurosurgical needs of a large population. Lessons from our experience can guide other departments as they triage neurosurgical cases to meet community needs.


Asunto(s)
COVID-19/epidemiología , Hospitales Universitarios/organización & administración , Neurocirugia/organización & administración , Procedimientos Neuroquirúrgicos/estadística & datos numéricos , Centros Médicos Académicos/organización & administración , Neoplasias Encefálicas/cirugía , COVID-19/diagnóstico , Prueba de Ácido Nucleico para COVID-19 , Prueba Serológica para COVID-19 , California/epidemiología , Derivaciones del Líquido Cefalorraquídeo/estadística & datos numéricos , Procedimientos Quirúrgicos Electivos , Procedimientos Endovasculares/estadística & datos numéricos , Capacidad de Camas en Hospitales , Departamentos de Hospitales/organización & administración , Humanos , Control de Infecciones , Difusión de la Información/métodos , Unidades de Cuidados Intensivos , Laboratorios de Hospital , Sistemas Multiinstitucionales , Quirófanos , Política Organizacional , Equipo de Protección Personal/provisión & distribución , Estudios Retrospectivos , Medición de Riesgo , SARS-CoV-2 , Capacidad de Reacción , Triaje , Procedimientos Quirúrgicos Vasculares/estadística & datos numéricos , Ventiladores Mecánicos/provisión & distribución , Heridas y Lesiones/cirugía
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