Case Volumes and Perioperative COVID-19 Incidence in Neurosurgical Patients During a Pandemic: Experiences at Two Tertiary Care Centers in Washington, DC. - 2020

CONCLUSION: There is a small but real risk of perioperative COVID-19 in neurosurgical patients, and those patients tend to have a higher complication rate. The mMeNTS score may play a role in decision making for scheduling elective cases. Further studies are warranted to develop risk stratification and validate incidence. Copyright (c) 2020 Elsevier Inc. All rights reserved. METHODS: Neurosurgical and neurointerventional procedures at two tertiary care centers during the pandemic were reviewed. Case volume, type, and acuity were compared to same time period in 2019. Perioperative COVID-19 tests and results were evaluated to obtain incidence. Baseline characteristics, including a modified Medically Necessary Time Sensitive (mMeNTS) score, and outcome measures were compared between COVID-19 positive and negative patients. OBJECTIVE: The true incidence of perioperative COVID-19 is not well elucidated in the neurosurgical literature. We aim to review the impact of the pandemic on neurosurgical case volume, to study the incidence of COVID-19 in patients undergoing these procedures during the perioperative period, and to compare characteristics and outcomes of this group to COVID-19 negative patients. RESULTS: 405 cases were reviewed and there was a significant decrease in total spine, cervical spine, lumbar spine, and functional/pain cases. There were no significant differences in cranial and neurointerventional cases. Of patients tested, 5.4% (18/334) were positive for COVID-19. Five of these patients were diagnosed postoperatively. mMeNTS score, complications, and case acuity were significantly different between COVID-19 positive and negative patients.


English

1878-8750

10.1016/j.wneu.2020.08.015 [doi] S1878-8750(20)31779-4 [pii]


*Elective Surgical Procedures/sn [Statistics & Numerical Data]
*Neurosurgery/sn [Statistics & Numerical Data]
Adult
District of Columbia
Female
Humans
Incidence
Male
Neurosurgical Procedures/sn [Statistics & Numerical Data]
Tertiary Care Centers
Young Adult


MedStar Washington Hospital Center


Neurosurgery
Surgery/General Surgery


Journal Article