Letter: A Guide to the Prioritization of Neurosurgical Cases After the COVID-19 Pandemic

Thomas, Justin G.; Gandhi, Shashank; White, Timothy G; Jocelyn, Christian; Soo, Teck M; Eisenberg, Mark J.; Schulder, Michael; Narayan, Raj

doi:10.1093/neuros/nyaa251

Cited by 9 publications

(5 citation statements)

References 12 publications

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“…In a single-center study from Texas, top surgical priority patients are those with large masses, progressive neurologic decline, severe pain, no nonsurgical options, or when diagnosis via surgery is required to initiate therapy [19]. Another study recommended using the Delphi method by an expert panel to assess the urgency of different neurosurgical interventions [20]. Bajunaid et al from the Saudi Arabian Neurosurgical Association recommended surgery for all intracranial tumors affecting consciousness, causing hemodynamic instability, or acute vision loss due to optic nerve/chiasm compression [16].…”

Section: Patient Triagementioning

confidence: 99%

Impact of a pandemic on surgical neuro-oncology—maintaining functionality in the early phase of crisis

et al. 2021

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Background The Coronavirus disease 2019 (COVID-19) pandemic has extraordinarily impacted global healthcare. Neuro-oncological surgery units have peculiar features that make them highly relevant in the strategic reaction to the pandemic. In this Chinese Society of Neuro-Oncology (CSNO) initiated survey, we appraise the changes implemented in neuro-oncological surgery hospitals across different Asian countries and provide expert recommendations for responses at different stages of the pandemic. Methods We performed a 42-question survey of the early experience of neuro-oncological surgery practice in hospitals across different Asian countries on April 1, 2020, with responses closed on April 18, 2020. Results 144 hospitals completed the questionnaire. Most were in WHO post-peak phase of the pandemic and reported a median reduction in neuro-oncological surgery volume of 25–50%. Most (67.4%) resumed elective surgery in only COVID-19 negative patients;11.1% performed only emergency cases irrespective of COVID-19 status;2.1% suspended all surgical activity. Ninety-one (63.2%) relocated personnel from neurosurgery to other departments. Fifty-two (36.1%) hospitals suspended post-operative adjuvant therapy and 94 (65.2%) instituted different measures to administer post-operative adjuvant therapy. Majority (59.0%) of the hospitals suspended research activity. Most (70%) respondents anticipate that current neurosurgery restrictions will continue to remain for > 1 month. Conclusions Majority of the respondents to our survey reported reduced neuro-oncological surgery activity, policy modification, personnel reallocation, and curtailment of educational/research activities in response to the COVID-19 pandemic. The persistent widespread interruption of surgical neuro-oncology in even post-peak phases of the pandemic raises serious concerns about the long-term impact of the pandemic on neuro-oncological patients and highlights the essence of timely measures for pandemic preparedness, patient triage, and workforce protection.

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Section: Patient Triagementioning

confidence: 99%

Impact of a pandemic on surgical neuro-oncology—maintaining functionality in the early phase of crisis

et al. 2021

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“…1 The World Health Organization subsequently declared COVID-19 a global pandemic, and on March 13, 2020 the American College of Surgeons recommended the cessation of elective surgeries and the triaging of remaining cases by the level of acuity. [2][3][4] The recommendation was cemented across the United States when surgical departments were required to cancel all elective surgeries by executive order 5 to help to reduce the burden on the healthcare system during the pandemic. 6 Surveys of physicians across varied specialties have unanimously demonstrated marked disruptions in clinical practice due to the pandemic.…”

Section: Introductionmentioning

confidence: 99%

Trends in academic productivity in the COVID-19 era: analysis of neurosurgical, stroke neurology, and neurointerventional literature

Lee

Mohanty

Albuquerque

et al. 2020

J NeuroIntervent Surg

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BackgroundAcademic physicians aim to provide clinical and surgical care to their patients while actively contributing to a growing body of scientific literature. The coronavirus disease 2019 (COVID-19) pandemic has resulted in procedural-based specialties across the United States witnessing a sharp decline in their clinical volume and surgical cases.ObjectiveTo assess the impact of COVID-19 on neurosurgical, stroke neurology, and neurointerventional academic productivity.MethodsThe study compared the neurosurgical, stroke neurology, and neurointerventional academic output during the pandemic lockdown with the same time period in previous years. Editors from a sample of neurosurgical, stroke neurology, and neurointerventional journals provided the total number of original manuscript submissions, broken down by months, from the year 2016 to 2020. Manuscript submission was used as a surrogate metric for academic productivity.Results8 journals were represented. The aggregated data from all eight journals as a whole showed that a combined average increase of 42.3% was observed on original submissions for 2020. As the average yearly percent increase using the 2016–2019 data for each journal exhibited a combined average increase of 11.2%, the rise in the yearly increase for 2020 in comparison was nearly fourfold. For the same journals in the same time period, the average percent of COVID-19 related publications from January to June of 2020 was 6.87%.ConclusionThere was a momentous increase in the number of original submissions for the year 2020, and its effects were uniformly experienced across all of our represented journals.

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“…As a community, we have redeployed clinical and administrative resources to meet rapidly changing needs [1][2][3]. We shifted how we triage surgical cases and altered surgical protocols to protect patients and health care workers (HCWs) [4][5][6][7][8][9][10]. We adopted new technology to facilitate use of telemedicine to enable follow-up with our patients [1,2,7,11].…”

Section: To the Editormentioning

confidence: 99%

Letter: Comprehensive Neurosurgery Infection Prevention and Control Practice in the COVID-19 “Return to Operate” Era

Maragkos¹,

McNeill²,

Kessler³

et al. 2021

Journal of Scientific Innovation in Medicine

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The COVID-19 pandemic has forced neurosurgeons to adapt in the face of an unforeseen crisis, including reevaluating an important aspect of neurosurgical practice: surgical infection control and prevention. Before COVID-19, surgical site infections (SSI) remained a costly and burdensome issue within neurosurgery and the medical field at-large. Furthermore, as options for linking payment to quality of care and mandatory reporting of SSI expands, cranial and spine surgery can expect to face increased oversight and pressure in efforts to reduce SSI. The risk of COVID-19 transmission to both patients and healthcare workers has inspired rigorous attention to inspection control practices. Therefore, at our institution we have applied the momentum gained introducing new infection control practices and procedures to prevent of COVID-19 transmission to the adoption of a surgical infection control bundle. We describe our implementation spanning screening and selection of patients for surgery, intraoperative precautions, postoperative care, and systems for monitoring and feedback.

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Letter: A Guide to the Prioritization of Neurosurgical Cases After the COVID-19 Pandemic

Cited by 9 publications

References 12 publications

Impact of a pandemic on surgical neuro-oncology—maintaining functionality in the early phase of crisis

Impact of a pandemic on surgical neuro-oncology—maintaining functionality in the early phase of crisis

Trends in academic productivity in the COVID-19 era: analysis of neurosurgical, stroke neurology, and neurointerventional literature

Letter: Comprehensive Neurosurgery Infection Prevention and Control Practice in the COVID-19 “Return to Operate” Era

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