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ORIGINAL ARTICLE
Year : 2021  |  Volume : 16  |  Issue : 2  |  Page : 340-348

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


1 Departments of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
2 Department of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

Correspondence Address:
Dr. Nishant Goyal
Department of Neurosurgery, All India Institute of Medical Sciences, Veerbhadra Road, Rishikesh - 249 203, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajns.AJNS_497_20

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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.


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