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Perioperative Coronavirus Disease 2019 (COVID-19) Incidence and Outcomes in Neurosurgical Patients at Two Tertiary Care Centers in Washington, DC, During a Pandemic: A 6-Month Follow-up.
Sarpong, Kwadwo; Dowlati, Ehsan; Withington, Charles; Chesney, Kelsi; Mualem, William; Hay, Kathryn; Zhou, Tianzan; Black, Jordan; Shashaty, Matthew; Kalhorn, Christopher G; Nair, Mani N; Felbaum, Daniel R.
  • Sarpong K; Georgetown University School of Medicine, Washington, DC, USA.
  • Dowlati E; Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC, USA. Electronic address: edowlati@gmail.com.
  • Withington C; Georgetown University School of Medicine, Washington, DC, USA.
  • Chesney K; Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC, USA.
  • Mualem W; Georgetown University School of Medicine, Washington, DC, USA.
  • Hay K; Georgetown University School of Medicine, Washington, DC, USA.
  • Zhou T; Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC, USA.
  • Black J; Georgetown University School of Medicine, Washington, DC, USA.
  • Shashaty M; Georgetown University School of Medicine, Washington, DC, USA.
  • Kalhorn CG; Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC, USA.
  • Nair MN; Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC, USA.
  • Felbaum DR; Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC, USA; Department of Neurosurgery, MedStar Washington Hospital Center, Washington, DC, USA.
World Neurosurg ; 146: e1191-e1201, 2021 02.
Article in English | MEDLINE | ID: covidwho-1026721
ABSTRACT

OBJECTIVE:

Coronavirus disease 2019 (COVID-19) continues to affect all aspects of health care delivery, and neurosurgical practices are not immune to its impact. We aimed to evaluate neurosurgical practice patterns as well as the perioperative incidence of COVID-19 in neurosurgical patients and their outcomes.

METHODS:

A retrospective review of neurosurgical and neurointerventional cases at 2 tertiary centers during the first 3 months of the first peak of COVID-19 pandemic (March 8 to June 8) as well as following 3 months (post-peak pandemic; June 9 to September 9) was performed. Baseline characteristics, perioperative COVID-19 test results, modified Medically Necessary, Time-Sensitive (mMeNTS) score, and outcome measures were compared between COVID-19-positive and-negative patients through bivariate and multivariate analysis.

RESULTS:

In total, 652 neurosurgical and 217 neurointerventional cases were performed during post-peak pandemic period. Cervical spine, lumbar spine, functional/pain, cranioplasty, and cerebral angiogram cases were significantly increased in the postpandemic period. There was a 2.9% (35/1197) positivity rate for COVID-19 testing overall and 3.6% (13/363) positivity rate postoperatively. Age, mMeNTS score, complications, length of stay, case acuity, American Society of Anesthesiologists status, and disposition were significantly different between COVID-19-positive and-negative patients.

CONCLUSIONS:

A significant increase in elective case volume during the post-peak pandemic period is feasible with low and acceptable incidence of COVID-19 in neurosurgical patients. COVID-19-positive patients were younger, less likely to undergo elective procedures, had increased length of stay, had more complications, and were discharged to a location other than home. The mMeNTS score plays a role in decision-making for scheduling elective cases.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Perioperative Care / Neurosurgical Procedures / Tertiary Care Centers / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: World Neurosurg Journal subject: Neurosurgery Year: 2021 Document Type: Article Affiliation country: J.wneu.2020.11.133

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Perioperative Care / Neurosurgical Procedures / Tertiary Care Centers / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: World Neurosurg Journal subject: Neurosurgery Year: 2021 Document Type: Article Affiliation country: J.wneu.2020.11.133