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Impact of COVID-19 on a Neurosurgical Service: Lessons from the University of California San Diego.
Wali, Arvin R; Ryba, Bryan E; Kang, Keiko; Santiago-Dieppa, David R; Steinberg, Jeffrey; Diaz-Aguilar, Luis Daniel; Stone, Lauren E; Brandel, Michael G; Longhurst, Christopher A; Taylor, William; Khalessi, Alexander A.
  • Wali AR; Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.
  • Ryba BE; Department of Neurosurgery, University of California San Diego, La Jolla, California, USA. Electronic address: bryba@health.ucsd.edu.
  • Kang K; Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.
  • Santiago-Dieppa DR; Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.
  • Steinberg J; Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.
  • Diaz-Aguilar LD; Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.
  • Stone LE; Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.
  • Brandel MG; Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.
  • Longhurst CA; Department of Biomedical Informatics, University of California San Diego, La Jolla, California, USA.
  • Taylor W; Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.
  • Khalessi AA; Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.
World Neurosurg ; 148: e172-e181, 2021 04.
Article in English | MEDLINE | ID: covidwho-1078227
ABSTRACT

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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Neurosurgical Procedures / COVID-19 / Hospitals, University / Neurosurgery Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Country/Region as subject: North America Language: English Journal: World Neurosurg Journal subject: Neurosurgery Year: 2021 Document Type: Article Affiliation country: J.wneu.2020.12.103

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Neurosurgical Procedures / COVID-19 / Hospitals, University / Neurosurgery Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Country/Region as subject: North America Language: English Journal: World Neurosurg Journal subject: Neurosurgery Year: 2021 Document Type: Article Affiliation country: J.wneu.2020.12.103