Neurosurgical Care during the COVID-19 Pandemic in Central Germany: A Retrospective Single Center Study of the Second Wave

Abstract

The healthcare system has been placed under an enormous burden by the SARS-CoV-2 (COVID-19) pandemic. In addition to the challenge of providing sufficient care for COVID-19 patients, there is also a need to ensure adequate care for non-COVID-19 patients. We investigated neurosurgical care in a university hospital during the pandemic. We examined the second wave of the pandemic from 1 October 2020 to 15 March 2021 in this retrospective single-center study and compared it to a pre-pandemic period from 1 October 2019 to 15 March 2020. Any neurosurgical intervention, along with patient- and treatment-dependent factors, were recorded. We also examined perioperative complications and unplanned readmissions. A statistical comparison of the study groups was performed. We treated 535 patients with a total of 602 neurosurgical surgeries during the pandemic. This compares to 602 patients with 717 surgeries during the pre-pandemic period. There were 67 fewer patients (reduction to 88.87%) admitted and 115 fewer surgeries (reduction to 83.96%) performed, which were essentially highly elective procedures, such as cervical spinal stenosis, intracranial neurinomas, and peripheral nerve lesions. Regarding complication rates and unplanned readmissions, there was no significant difference between the COVID-19 pandemic and the non-pandemic patient group. Operative capacities were slightly reduced to 88% due to the pandemic. Nevertheless, comprehensive emergency and elective care was guaranteed in our university hospital. This speaks for the sufficient resources and high-quality processes that existed even before the pandemic.

Neurosurgical service during COVID-19 pandemics in Ljubljana, Slovenia - lessons learned

“…The flow of patients to health institutions has increased during the pandemic as the COVID-19 patients have joined patients with everyday health problems. This new reality needed to be addressed adequately and effectively 16,17 .…”

Management of neurosurgical patients during coronavirus disease 2019 pandemics: The Ljubljana, Slovenia experience

“…The flow of patients to the health institutions is not reduced during the epidemic, it is rather increased, and the current virus pathology is intermingled with the everyday health problems, which also need to be addressed adequately and professionally. This is particularly important for neurosurgery where the emergencies need to be handled quickly in order not to cause additional damage to the nervous system[ 28 , 29 ].…”

“…It is very important to manage patients in the operation theatres carefully and correctly, to limit the potential spread of the virus[ 29 - 31 ]. The separation of hospital areas into zones and rapid antigen testing are practical measures that have proven very successful.…”

Decompressive Surgery in the Treatment of Acute Ischemic Stroke during the First Four Waves of the COVID-19 Pandemic in Germany: A Nationwide Observational Cohort Study

“…The study with the latest study period within the pandemic era reports exclusively on wave 2 at one single center, at which 165 neurosurgical emergency operations were conducted and no changes in case load were observed, compared to pre-pandemic levels. [25] Another analysis from Germany examined 59 admissions for emergent neurosurgery in the wave 1 of the pandemic and found a decline in total case numbers by 37%. [26] Given that those studies are from single centers and report on neurosurgical emergencies in general, while our study is exclusively on decompressive surgery for stroke, a direct comparison is challenging.…”