ABSTRACT
Objective During the COVID-19 pandemic, certain precautionary measures were implemented to limit its effect, including the cancellation of clinics and elective surgical lists. To determine the impact, if any, of the pandemic on the running of a neurosurgical service, an audit was performed on the volume of referrals, admissions and type of surgeries performed at a tertiary institute in a low-resource setting. Methods An audit of the neurosurgical department's database was performed on the number of referrals, admissions, surgical procedures, and types of procedures done at the San Fernando General Hospital. This was divided into two 15-month periods, pre-pandemic (January 1, 2019 to March 31, 2020) and intra-pandemic (April 1, 2020 - June 30, 2021). Results During the pre-pandemic period (January 1, 2019 - March 31, 2020), 2,597 patients were referred to the service and 309 major procedures were performed. Two thousand and forty-two patients were referred during the intra-pandemic (April 4, 2020 - June 30, 2021) period, with 354 surgeries performed. More external ventricular drains (29 vs 50), craniotomies for trauma (73 vs 98), anterior cervical fusion (42 vs 47), lumbar fusions (9 vs 12), ventriculo-peritoneal shunts (16 vs 19) and aneurysm clipping (10 vs 13) were done during the intra-pandemic period. Conclusion Although elective surgical procedures and clinics were reduced, the number of patients seen and total procedures performed did not vary significantly. The neurosurgical pathology encountered remained constant during the pandemic. This shows the importance of maintaining a fully functional neurosurgical service, as we continue to adapt to the COVID-19 pandemic.
ABSTRACT
BACKGROUND: Cancellation of elective surgical operations is recognized as a major cause of emotional trauma to patients as well as their families. This study was carried out to assess the incidence, causes and pattern of cancellation of elective surgical operations in our setting and to find the appropriate solutions for better patient management. METHODS: This was a prospective hospital-based study which was conducted in a teaching hospital at Bugando medical Centre from March 2009 to February 2010. RESULTS: A total of 3,064 patients were scheduled for elective surgical operations. Of these, 644 (21.0%) patients' operations were cancelled. General surgery had the highest rate of cancellations (31.5%) followed by orthopaedic surgery in 25.5%. Lack of theatre space and theatre facilities were the most common causes of cancellations in 53.0% and 28.4% of cases respectively. The majority of these cancellations were attributable to hospital administration in 82.0 % and most of them were preventable in 93.8% of cases. The mean hospital stay was 28.46 days and it was significantly related to the number of cancellations (p < 0.001). CONCLUSION: Cancellation of elective surgical operations is a significant problem in our hospital. To prevent unnecessary cancellations, efforts should be made to enhance cost effectiveness through careful planning and efficient utilization of the few available hospital resources.