The provision of neuro-oncology and glioma neurosurgery during the SARS-CoV-2 pandemic: a single national tertiary centre experience.


Journal

Irish journal of medical science
ISSN: 1863-4362
Titre abrégé: Ir J Med Sci
Pays: Ireland
ID NLM: 7806864

Informations de publication

Date de publication:
Aug 2021
Historique:
received: 18 09 2020
accepted: 01 11 2020
pubmed: 7 11 2020
medline: 7 10 2021
entrez: 6 11 2020
Statut: ppublish

Résumé

The COVID-19 pandemic has resulted in a significant disruption in the provision of healthcare globally. The aim of this study was to assess the implications of the COVID-19 pandemic on the provision of neuro-oncology surgery and comparison with a similar 3-month period in 2019. Retrospective review of prospectively curated database of patients requiring neuro-oncology surgery at our tertiary referral centre between 1st March 2020 and 31st May 2020. We also analysed data for the same time period (1st March-31st May) in 2019 for comparison. Number and type of tumours operated on, postoperative morbidity and mortality, COVID-19-related complications and delays in treatment were recorded. During the 3-month periods studied in 2020 and 2019, there were 127 and 139 admissions for neuro-oncological surgery, respectively. Sixty patients underwent surgery for gliomas during the 2020 period vs 56 in the 2019 period. We observed no increase in mean length of time from referral to inter-hospital transfer (mean of 76 h in 2020 vs 93 h in 2019 (p = 0.10)) or in mean length of time from admission to surgery in the acute admissions (2.39 days in 2020 vs 2.89 days in 2019). The postoperative 30-day morbidity and mortality rates were lower in 2020; 8.7% (n = 11) compared with 10.1% (n = 14) in 2019. There was one COVID-19-related death which occurred in a patient with B cell lymphoma with negative preoperative COVID-19 test. The provision of neuro-oncological surgery can be safely continued during respiratory illness epidemic or pandemic if a rigorous testing and staffing framework is implemented.

Sections du résumé

BACKGROUND BACKGROUND
The COVID-19 pandemic has resulted in a significant disruption in the provision of healthcare globally. The aim of this study was to assess the implications of the COVID-19 pandemic on the provision of neuro-oncology surgery and comparison with a similar 3-month period in 2019.
METHODS METHODS
Retrospective review of prospectively curated database of patients requiring neuro-oncology surgery at our tertiary referral centre between 1st March 2020 and 31st May 2020. We also analysed data for the same time period (1st March-31st May) in 2019 for comparison. Number and type of tumours operated on, postoperative morbidity and mortality, COVID-19-related complications and delays in treatment were recorded.
RESULTS RESULTS
During the 3-month periods studied in 2020 and 2019, there were 127 and 139 admissions for neuro-oncological surgery, respectively. Sixty patients underwent surgery for gliomas during the 2020 period vs 56 in the 2019 period. We observed no increase in mean length of time from referral to inter-hospital transfer (mean of 76 h in 2020 vs 93 h in 2019 (p = 0.10)) or in mean length of time from admission to surgery in the acute admissions (2.39 days in 2020 vs 2.89 days in 2019). The postoperative 30-day morbidity and mortality rates were lower in 2020; 8.7% (n = 11) compared with 10.1% (n = 14) in 2019. There was one COVID-19-related death which occurred in a patient with B cell lymphoma with negative preoperative COVID-19 test.
CONCLUSION CONCLUSIONS
The provision of neuro-oncological surgery can be safely continued during respiratory illness epidemic or pandemic if a rigorous testing and staffing framework is implemented.

Identifiants

pubmed: 33155104
doi: 10.1007/s11845-020-02429-7
pii: 10.1007/s11845-020-02429-7
pmc: PMC7643863
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

905-911

Informations de copyright

© 2020. Royal Academy of Medicine in Ireland.

Références

COVIDSurg Collaborative (2020) Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: An international cohort study. Lancet (London, England) 396(10243):27–38. https://doi.org/10.1016/s0140-6736(20)31182-x
National Health Service (NHS) (2020) Specialty guides for patient management during the coronavirus pandemic - Clinical guide for the management of cancer patients during the coronavirus pandemic. https://www.uhb.nhs.uk/coronavirus-staff/downloads/pdf/CoronavirusCancerManagement.pdf . Accessed 4 Sept 2020
Society of British Neurological Surgeons (2020) Adult Neuro-oncology service provision during COVID-19 outbreak. https://www.sbns.org.uk/index.php/policies-and-publications/covid/ . Accessed 4 Sept 2020
COVIDSurg Collaborative (2020) Global guidance for surgical care during the COVID-19 pandemic. Br J Surg. https://doi.org/10.1002/bjs.11646
Bernhardt D, Wick W, Weiss SE et al (2020) Neuro-oncology management during the COVID-19 pandemic with a focus on WHO grade III and IV Gliomas. Neuro-Oncology 22(7):928–935. https://doi.org/10.1093/neuonc/noaa113
doi: 10.1093/neuonc/noaa113 pmcid: 7239150

Auteurs

Michael Amoo (M)

National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland. michaelamoo@rcsi.ie.
Royal College of Surgeons in Ireland, Dublin, Ireland. michaelamoo@rcsi.ie.

Jack Horan (J)

National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland.

Brian Gilmartin (B)

National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland.

Deirdre Nolan (D)

National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland.

Paula Corr (P)

National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland.

Stephen MacNally (S)

National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland.

Mohammed Ben Husien (MB)

National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland.
Royal College of Surgeons in Ireland, Dublin, Ireland.

Mohsen Javadpour (M)

National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland.
Royal College of Surgeons in Ireland, Dublin, Ireland.
Department of Academic Neurology, Trinity College Dublin, Dublin, Ireland.

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