Elsevier

World Neurosurgery

Volume 148, April 2021, Pages e172-e181
World Neurosurgery

Original Article
Impact of COVID-19 on a Neurosurgical Service: Lessons from the University of California San Diego

https://doi.org/10.1016/j.wneu.2020.12.103Get rights and content
Under a Creative Commons license
open access

Background

The institution-wide response of the University of California San Diego Health system to the 2019 novel coronavirus disease (COVID-19) pandemic was founded on rapid development of in-house testing capacity, optimization of personal protective equipment usage, expansion of intensive care unit capacity, development of analytic dashboards for monitoring of institutional status, and implementation of an operating room (OR) triage plan that postponed nonessential/elective procedures. We analyzed the impact of this triage plan on the only academic neurosurgery center in San Diego County, California, USA.

Methods

We conducted a de-identified retrospective review of all operative cases and procedures performed by the Department of Neurosurgery from November 24, 2019, through July 6, 2020, a 226-day period. Statistical analysis involved 2-sample z tests assessing daily case totals over the 113-day periods before and after implementation of the OR triage plan on March 16, 2020.

Results

The neurosurgical service performed 1429 surgical and interventional radiologic procedures over the study period. There was no statistically significant difference in mean number of daily total cases in the pre–versus post–OR triage plan periods (6.9 vs. 5.8 mean daily cases; 1-tail P = 0.050, 2-tail P = 0.101), a trend reflected by nearly every category of neurosurgical cases.

Conclusions

During the COVID-19 pandemic, the University of California San Diego Department of Neurosurgery maintained an operative volume that was only modestly diminished and continued to meet the essential neurosurgical needs of a large population. Lessons from our experience can guide other departments as they triage neurosurgical cases to meet community needs.

Key words

COVID-19
Elective
Essential
Operative volume

Abbreviations and Acronyms

COVID-19
2019 novel coronavirus disease
ICU
Intensive care unit
IR
Interventional radiology
OR
Operating room
PCR
Polymerase chain reaction
PPE
Personal protective equipment
UC
University of California

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Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Arvin R. Wali and Bryan E. Ryba are co–first authors.