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Sheltered Neurosurgery During COVID-19: The Emory Experience.
Saad, Hassan; Alawieh, Ali; Oyesiku, Nelson; Barrow, Daniel L; Olson, Jeffrey.
  • Saad H; Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Alawieh A; Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Oyesiku N; Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Barrow DL; Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Olson J; Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA. Electronic address: jolson@emory.edu.
World Neurosurg ; 144: e204-e209, 2020 12.
Article in English | MEDLINE | ID: covidwho-720739
ABSTRACT

BACKGROUND:

The 2019 novel coronavirus disease (COVID-19) pandemic has directly and indirectly impacted health care systems, including residency programs. Social distancing, cancellation of elective cases, and staff re-deployment have compromised clinical and academic teaching. We describe the neurosurgical experience at Emory University during the COVID-19 pandemic and the impact of COVID-19-related policies on resident experience.

METHODS:

We retrospectively reviewed all neurosurgical cases performed at Emory University Hospital between March 16, the day cancellation of elective cases was effective, and April 15, 2020, and the same period in the preceding 3 years. For the study period, we collected the number of cases and their distribution by subspecialty along with total hospital charges.

RESULTS:

Compared with an average of 606 cases performed during the study period over the past 3 years, only 145 neurosurgical cases were performed between March 16 and April 15, 2020, which corresponds to an 80% reduction in case volume and 66% decrease in hospital revenue in 2020. When divided by subspecialty, the most significant reduction was observed in functional (84%; P < 0.01) followed by spine (78%; P < 0.01) surgery, although all subspecialties were significantly impacted. Assessing junior resident experience, we observed a significant reduction in number of neurosurgical admissions (47%; P < 0.01) and bedside procedures (59%; P < 0.01) in the study period in 2020 compared with the past 3 years, with no significant reduction in number of consultations (17%; P > 0.1).

CONCLUSIONS:

Even at academic centers that were not hugely impacted by the COVID-19 pandemic, prophylactic and preparedness measures still exhibited an unprecedented toll on neurosurgical resident and fellow experience.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vascular Surgical Procedures / Elective Surgical Procedures / Neurosurgical Procedures / Education, Medical, Graduate / COVID-19 / Hospitalization / Neurosurgery Type of study: Observational study / Prognostic study Limits: Humans Country/Region as subject: North America Language: English Journal: World Neurosurg Journal subject: Neurosurgery Year: 2020 Document Type: Article Affiliation country: J.wneu.2020.08.082

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vascular Surgical Procedures / Elective Surgical Procedures / Neurosurgical Procedures / Education, Medical, Graduate / COVID-19 / Hospitalization / Neurosurgery Type of study: Observational study / Prognostic study Limits: Humans Country/Region as subject: North America Language: English Journal: World Neurosurg Journal subject: Neurosurgery Year: 2020 Document Type: Article Affiliation country: J.wneu.2020.08.082