Does COVID-19 affect survival and functional outcome in emergency and urgent neurosurgical procedures? A single center prospective experience during the pandemic

Autor: Luigi Gianmaria Remore, Luigi Schisano, Stefano Borsa, Mauro Pluderi, Giorgio Fiore, Giulio Bertani, Marco Locatelli, Leonardo Tariciotti, Giorgio Carrabba
Přispěvatelé: Fiore, G, Remore, L, Tariciotti, L, Carrabba, G, Schisano, L, Pluderi, M, Bertani, G, Borsa, S, Locatelli, M
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Operating Rooms
medicine.medical_treatment
ICH
intracerebral hemorrhage
Single Center
KPS
Karnofsky performance status scale
LOS
Length of in-ward stay
Neurosurgical Procedures
Infectious Disease Transmission
Professional-to-Patient
COVID-19 Testing
Pandemic
Prospective Studies
Craniotomy
BH
Burr hole
Aged
80 and over
Middle Aged
Treatment Outcome
Italy
EVD
external ventricular drain
Original Article
Female
medicine.symptom
VPS
ventriculoperitoneal shunt
Urgent surgery
PPE
personal protective equipment
Sars-Cov-2 infection
medicine.medical_specialty
Infectious Disease Transmission
Patient-to-Professional
Coronavirus disease 2019 (COVID-19)
Burr holes
Neurosurgery
COVID-19
Corona Virus Disease 19
Perioperative Care
medicine
OR
operating room
Sars-CoV-2
Severe acute respiratory syndrome coronavirus 2
Humans
Pandemics
Personal Protective Equipment
Aged
Coma
CSF
Cerebrospinal fluid
Infection Control
business.industry
SARS-CoV-2
Neurological status
COVID-19
Infant
Length of Stay
medicine.disease
Survival Analysis
Surgery
Hydrocephalus
Neurosurgical outcome
Neurology (clinical)
SAH
subarachnoid hemorrhage
Emergencies
business
GCS
Glasgow Coma Scale score
Zdroj: World Neurosurgery
ISSN: 1878-8769
1878-8750
Popis: Objective To assess organizational and technical difficulties of neurosurgical procedures during the coronavirus disease 2019 (COVID-19) pandemic and their possible impact on survival and functional outcome and to evaluate virological exposure risk of medical personnel. Methods Data for all urgent surgical procedures performed in the COVID-19 operating room were prospectively collected. Preoperative and postoperative variables included demographics, pathology, Karnofsky performance status (KPS) and neurological status at admission, type and duration of surgical procedures, length of stay, postoperative KPS and functional outcome comparison, and destination at discharge. We defined 5 classes of pathologies (traumatic, oncological, vascular, infection, hydrocephalus) and 4 surgical categories (burr hole, craniotomy, cerebrospinal fluid shunting, spine surgery). Postoperative SARS-CoV-2 infection was checked in all the operators. Results We identified 11 traumatic cases (44%), 4 infections (16%), 6 vascular events (24%), 2 hydrocephalus conditions (8%), and 2 oncological cases (8%). Surgical procedures included 11 burr holes (44%), 7 craniotomies (28%), 6 cerebrospinal fluid shunts (24%), and 1 spine surgery (4%). Mean patient age was 57.8 years. The most frequent clinical presentation was coma (44 cases). Mean KPS score at admission was 20 ± 10, mean surgery duration was 85 ± 63 minutes, and mean length of stay was 27 ± 12 days. Mean KPS score at discharge was 35 ± 25. Outcome comparison showed improvement in 16 patients. Four patients died. Mean follow-up was 6 ± 3 months. None of the operators developed postoperative SARS-CoV-2 infection. Conclusions Standardized protocols are mandatory to guarantee a high standard of care for emergency and urgent surgeries during the COVID-19 pandemic. Personal protective equipment affects maneuverability, dexterity, and duration of interventions without affecting survival and functional outcome.
Databáze: OpenAIRE
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