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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(02): 340-348
DOI: 10.4103/ajns.AJNS_497_20
Original Article

Getting Neurosurgery Services Back on Its Feet: “Learning to Live” with COVID-19

Nishant Goyal
Departments of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
,
Kanav Gupta
1   Department of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
,
Jitender Chaturvedi
1   Department of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
,
Srikant Swain
1   Department of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
,
Akhil Tomy
1   Department of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
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Background: Cancellation/postponement of ”non-emergent” surgeries during coronavirus disease of 2019 (COVID-19) pandemic has created a huge backlog of patients waiting for surgery and has put them at risk of disease progression. We share our institute's policy and our department's attempt to resume ”non-emergent” surgeries. Materials and Methods: We collected details of all patients operated under department of neurosurgery since the onset of COVID-19 pandemic in India and categorized them into ”lockdown” and ”unlock” groups for comparison. COVID-19 tests done in these patients were also analyzed. We also compared our surgical volume with the number of COVID-19 cases in the state. Results: One hundred and forty-eight patients (97 males, 51 females) with mean age of 37.8 years (range-2 months-82 years) underwent surgery in our department during the study period. The operative volume per week increased by 37% during the ”unlock” period as compared to ”lockdown” period. The proportion of elective/”non-emergent” surgeries increased from 11.3% during ”lockdown” to 34.7% during the ”unlock” period (P = 0.0037). During ”lockdown” period, number of surgeries declined steadily as the number of COVID-19 cases rose in the state (rs(8) = −0.914, P = 0.000). Whereas there was a trend toward increased number of cases done per week despite increase in the number of cases in the state during the “unlock” period. During the ”unlocking” process, in-patient department admissions and surgeries performed per month increased (P = 0.0000) and this increase was uniform across all specialties. COVID-19 test was done (preoperatively or postoperatively) for all surgeries during ”unlock” period compared to 12 (22.6%) surgeries during ”lockdown” period. Three neurosurgery patients who underwent surgery during the ”unlock” period tested positive for COVID-19. Conclusions: Our experience shows that proper evidence-based protocols, setting up of adequate COVID-19 testing facilities and provision of ample personal protective equipments are instrumental in re-starting “nonemergent” surgeries.

Key-words:

Coronavirus disease of 2019 (COVID-19) - coronavirus disease of 2019 testing - elective surgeries - emergency surgeries - nonemergent surgeries - pandemic - routine surgeries

Financial support and sponsorship

Nil.




Publication History

Received: 20 November 2020

Accepted: 24 February 2021

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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