Patients awaiting surgery for neurosurgical diseases during the first wave of the COVID-19 pandemic in Spain: a multicentre cohort study.

Autor:	Castaño-Leon AM; Neurosurgery Department, Hospital Universitario 12 de Octubre, Madrid, Spain ana.maria.castano.leon@gmail.com.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain., Paredes I; Neurosurgery Department, Hospital Universitario 12 de Octubre, Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.; Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain., Lagares A; Neurosurgery Department, Hospital Universitario 12 de Octubre, Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.; Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain., Gomez PA; Neurosurgery Department, Hospital Universitario 12 de Octubre, Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain., González-Leon P; Neurosurgery Department, Hospital Universitario 12 de Octubre, Madrid, Spain., Perez-Nuñez A; Neurosurgery Department, Hospital Universitario 12 de Octubre, Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.; Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain., Jiménez-Roldán L; Neurosurgery Department, Hospital Universitario 12 de Octubre, Madrid, Spain.; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.; Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain., Delgado-Fernández J; Neurosurgery Department, Hospital Universitario 12 de Octubre, Madrid, Spain., Eiriz Fernández C; Neurosurgery Department, Hospital Universitario 12 de Octubre, Madrid, Spain., García-Pérez D; Neurosurgery Department, Hospital Universitario 12 de Octubre, Madrid, Spain., Moreno-Gómez LM; Neurosurgery Department, Hospital Universitario 12 de Octubre, Madrid, Spain., Esteban-Sinovas O; Neurosurgery Department, Hospital Universitario 12 de Octubre, Madrid, Spain., Delgado-López PD; Neurosurgery Department, Hospital Universitario de Burgos, Burgos, Spain., Martín-Alonso J; Neurosurgery Department, Hospital Universitario de Burgos, Burgos, Spain., Kaen A; Neurosurgery Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain., Tirado-Caballero J; Neurosurgery Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain., Ordóñez-Carmona M; Neurosurgery Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain., Arteaga-Romero F; Neurosurgery Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain., González-Pombo M; Neurosurgery Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain., F Alén J; Neurosurgery Department, Hospital Universitario de la Princesa, Madrid, Spain., Gil-Simoes R; Neurosurgery Department, Hospital Universitario de la Princesa, Madrid, Spain., Torres CV; Neurosurgery Department, Hospital Universitario de la Princesa, Madrid, Spain., Navas-García M; Neurosurgery Department, Hospital Universitario de la Princesa, Madrid, Spain., Blasco García de Andoain G; Neurosurgery Department, Hospital Universitario de la Princesa, Madrid, Spain., Frade-Porto N; Neurosurgery Department, Hospital Universitario de la Princesa, Madrid, Spain., González-Tarno P; Neurosurgery Department, Hospital Universitario de la Princesa, Madrid, Spain., Martin Segura A; Neurosurgery Department, Hospital Universitario de la Princesa, Madrid, Spain., Gelabert-González M; Neurosurgery Department, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain., Menéndez-Cortezón B; Neurosurgery Department, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain., Rodríguez-Botana B; Neurosurgery Department, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain., Pérez-Alfayate R; Neurosurgery Department, Hospital Clinico Universitario San Carlos, Madrid, Spain., Fernández-García C; Neurosurgery Department, Hospital Clinico Universitario San Carlos, Madrid, Spain., Ferrández-Pujante B; Neurosurgery Department, Hospital Clinico Universitario San Carlos, Madrid, Spain., Vargas-Jiménez AC; Neurosurgery Department, Hospital Clinico Universitario San Carlos, Madrid, Spain., Cotúa C; Neurosurgery Department, Hospital Clinico Universitario San Carlos, Madrid, Spain., de la Lama A; Neurosurgery Department, Complejo Hospitalario de Vigo Alvaro Cunqueiro, Vigo, Spain., Calero Félix L; Neurosurgery Department, Complejo Hospitalario de Vigo Alvaro Cunqueiro, Vigo, Spain., Ruiz-Juretschke F; Neurosurgery Department, Hospital General Universitario Gregorio Maranon, Madrid, Spain., García-Leal R; Neurosurgery Department, Hospital General Universitario Gregorio Maranon, Madrid, Spain., Valera-Melé M; Neurosurgery Department, Hospital General Universitario Gregorio Maranon, Madrid, Spain., Casitas Hernando V; Neurosurgery Department, Hospital General Universitario Gregorio Maranon, Madrid, Spain., Rivero B; Neurosurgery Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain., Orduna-Martínez J; Neurosurgery Department, Hospital Universitario Miguel Servet, Zaragoza, Spain., Casado Pellejero J; Neurosurgery Department, Hospital Universitario Miguel Servet, Zaragoza, Spain., Fustero De Miguel D; Neurosurgery Department, Hospital Universitario Miguel Servet, Zaragoza, Spain., Díaz Molina J; Neurosurgery Department, Hospital Universitario Miguel Servet, Zaragoza, Spain., Moles Herbera J; Neurosurgery Department, Hospital Universitario Miguel Servet, Zaragoza, Spain., Castelló-Ruiz MJ; Neurosurgery Department, Complejo Hospitalario Universitario Torrecardenas, Almeria, Spain., Gomar-Alba M; Neurosurgery Department, Complejo Hospitalario Universitario Torrecardenas, Almeria, Spain., García-Pérez F; Neurosurgery Department, Complejo Hospitalario Universitario Torrecardenas, Almeria, Spain., Hernández-García BJ; Neurosurgery Department, Hospital Universitario La Paz, Madrid, Spain., Villaseñor-Ledezma JJ; Neurosurgery Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., Otero-Rodríguez Á; Neurosurgery Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., Ailagas de Las Heras JJ; Neurosurgery Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., Gonçalves-Estella J; Neurosurgery Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., Sousa-Casasnovas P; Neurosurgery Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., Pascual-Argente D; Neurosurgery Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., Ruiz Martín L; Neurosurgery Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., Roa Montes de Oca JC; Neurosurgery Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., Arandia Guzmán D; Neurosurgery Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., García Martín A; Neurosurgery Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., Torres Carretero L; Neurosurgery Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., Garrido Ruiz A; Neurosurgery Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., Calvo M; Neurosurgery Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain., Miranda-Lloret P; Neurosurgery Department, Hospital Politécnico y Universitario La Fe, Valencia, Spain., Rodríguez-Cadarso M; Neurosurgery Department, Hospital Politécnico y Universitario La Fe, Valencia, Spain., Antón J; Neurosurgery Department, Hospital Politécnico y Universitario La Fe, Valencia, Spain., Roca Barber A; Neurosurgery Department, Hospital Politécnico y Universitario La Fe, Valencia, Spain., Quiroz-Tejada A; Neurosurgery Department, Hospital Politécnico y Universitario La Fe, Valencia, Spain., Carbayo-Lozano G; Neurosurgery Department, Hospital Universitario Cruces, Barakaldo, Spain., Bermúdez G; Neurosurgery Department, Hospital Universitario Cruces, Barakaldo, Spain., Paternain Martin C; Neurosurgery Department, Hospital Universitario Cruces, Barakaldo, Spain., De la Fuente Villa P; Neurosurgery Department, Hospital Universitario Cruces, Barakaldo, Spain., Fidalgo De la Rosa M; Neurosurgery Department, Hospital Universitario Cruces, Barakaldo, Spain., Sistiaga-Gracia ÍL; Neurosurgery Department, Hospital Universitario Cruces, Barakaldo, Spain., Zabalo G; Neurosurgery Department, Hospital Universitario Cruces, Barakaldo, Spain.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2022 Aug 17; Vol. 12 (8), pp. e061208. Date of Electronic Publication: 2022 Aug 17.
DOI:	10.1136/bmjopen-2022-061208
Abstrakt:	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<0.001), degenerative spine (OR=0.296, p=0.027) and expedited indications (OR=6.095, p<0.001) were independent factors for being operated on during the pandemic. Conclusions: Patients awaiting neurosurgery experienced significant collateral damage even when they were considered for scheduled procedures. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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