학술논문
Patients awaiting surgery for neurosurgical diseases during the first wave of the COVID-19 pandemic in Spain: a multicentre cohort study
Document Type
article
Author
Pedro A Gomez; Alfonso Lagares; Ana M Castaño-León; Angel Pérez-Nuñez; Igor Paredes; Pedro González-Leon; Juan Delgado-Fernandez; Daniel García-Pérez; Olga Esteban-Sinovas; Javier Martín-Alonso; Ariel Kaen; Jorge Tirado-Caballero; Ricardo Gil-Simoes; Cristina V Torres; Natalia Frade-Porto; Patricia González-Tarno; Adrian Martin Segura; Miguel Gelabert-Gonzalez; Rebeca Pérez-Alfayate; Carlos Cotúa; Adolfo de la Lama; Fernando Ruiz-Juretschke; Vicente Casitas Hernando; Juan Casado Pellejero; David Fustero De Miguel; Jesus Moles Herbera; Jesús Goncalves-Estella; Laura Ruiz Martín; Daniel Arandia Guzmán; Andoni García Martín; Luis Torres Carretero; Marta Calvo; Pablo Miranda-Lloret; Amparo Roca Barber; Clara Paternain Martin; Marina Fidalgo De la Rosa; Luis Jiménez-Roldán; Carla Eiriz Fernández; Luis M Moreno-Gómez; Pedro D Delgado-López; Marta Ordóñez-Carmona; Francisco Arteaga-Romero; Marta González-Pombo; José F Alén; Marta Navas-García; Guillermo Blasco García de Andoain; Beatriz Menéndez-Cortezón; Brais Rodríguez-Botana; Carla Fernández-García; Borja Ferrández-Pujante; Andres C Vargas-Jiménez; Lourdes Calero Félix; Roberto García-Leal; Marc Valera-Melé; Belén Rivero; Javier Orduna-Martínez; Jorge Díaz Molina; Maria J Castelló-Ruiz; Mario Gomar-Alba; Fernando García-Pérez; Borja J Hernández-García; Jorge J Villaseñor-Ledezma; Álvaro Otero-Rodríguez; Juan J Ailagas de las Heras; Pablo Sousa-Casasnovas; Daniel Pascual-Argente; Juan C Roa Montes de Oca; Alejandra Garrido Ruiz; Miguel Rodríguez-Cadarso; Joan Antón; Arnold Quiroz-Tejada; Guillermo Carbayo-Lozano; Garazi Bermúdez; Pablo De la Fuente Villa; Íñigo L Sistiaga-Gracia; Gorka Zabalo
Source
BMJ Open, Vol 12, Iss 8 (2022)
Subject
Language
English
ISSN
2044-6055
Abstract
Objectives The large number of infected patients requiring mechanical ventilation has led to the postponement of scheduled neurosurgical procedures during the first wave of the COVID-19 pandemic. The aims of this study were to investigate the factors that influence the decision to postpone scheduled neurosurgical procedures and to evaluate the effect of the restriction in scheduled surgery adopted to deal with the first outbreak of the COVID-19 pandemic in Spain on the outcome of patients awaiting surgery.Design This was an observational retrospective study.Settings A tertiary-level multicentre study of neurosurgery activity between 1 March and 30 June 2020.Participants A total of 680 patients awaiting any scheduled neurosurgical procedure were enrolled. 470 patients (69.1%) were awaiting surgery because of spine degenerative disease, 86 patients (12.6%) due to functional disorders, 58 patients (8.5%) due to brain or spine tumours, 25 patients (3.7%) due to cerebrospinal fluid (CSF) disorders and 17 patients (2.5%) due to cerebrovascular disease.Primary and secondary outcome measures The primary outcome was mortality due to any reason and any deterioration of the specific neurosurgical condition. Second, we analysed the rate of confirmed SARS-CoV-2 infection.Results More than one-quarter of patients experienced clinical or radiological deterioration. The rate of worsening was higher among patients with functional (39.5%) or CSF disorders (40%). Two patients died (0.4%) during the waiting period, both because of a concurrent disease. We performed a multivariate logistic regression analysis to determine independent covariates associated with maintaining the surgical indication. We found that community SARS-CoV-2 incidence (OR=1.011, p