A snapshot of European neurosurgery December 2019 vs. March 2020: just before and during the Covid-19 pandemic.
- Mathiesen T Department of Neurosurgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. Tiit.illimar.mathiesen@regionh.dk.
- Arraez M Department of Neurosurgery, Carlos Haya University Hospital,, University of Malaga, Malaga, Spain.
- Asser T University of Tartu, Tartu, Estonia.
- Balak N Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Education and Research Hospital, Istanbul, Turkey.
- Barazi S King's College Hospital, London, UK.
- Bernucci C Department of Neuroscience and Surgery of the Nervous System, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy.
- Bolger C National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland.
- Broekman MLD Departments of Neurosurgery, Haaglanden Medical Center and Leiden University Medical Center, Leiden University, Leiden, Zuid-Holland, the Netherlands.
- Demetriades AK Department of Neurosurgery, Western General Hospital, Edinburgh, UK.
- Feldman Z Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel.
- Fontanella MM Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia, Brescia, Italy.
- Foroglou N Department of Neurosurgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece.
- Lafuente J Neurosurgery, Hospital Del Mar, Barcelona, Spain.
- Maier AD Department of Neurosurgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
- Meyer B Department of Neurosurgery, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany.
- Niemelä M Helsinki University and Helsinki University Hospital, Helsinki, Finland.
- Roche PH Department of Neurosurgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Aix Marseille Université, Marseille, France.
- Sala F Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, Verona, Italy.
- Samprón N Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Spain.
- Sandvik U Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
- Schaller K Department of Neurosurgery, Geneva University Medical Center & Faculty of Medicine, Geneva, Switzerland.
- Thome C Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria.
- Thys M Neurosciences Department, Grand Hopital de Charleroi, Charleroi, Belgium.
- Tisell M Department of Neurosurgery, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, Göteborg, Sweden.
- Vajkoczy P Department of Neurosurgery, Charite Universitätsmedizin Berlin, Berlin, Germany.
- Visocchi M Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy.
- 2020-07-10
Published in:
- Acta neurochirurgica. - 2020
Covid-19
Epidemic
Europe
Healthcare management
Neurosurgery
Pandemic
SARS-CoV-2
Coronavirus Infections
Europe
Health Resources
Health Services Needs and Demand
Humans
Intensive Care Units
Neurosurgical Procedures
Pandemics
Pneumonia, Viral
Surgery Department, Hospital
Surveys and Questionnaires
English
BACKGROUND
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or Covid-19), which began as an epidemic in China and spread globally as a pandemic, has necessitated resource management to meet emergency needs of Covid-19 patients and other emergent cases. We have conducted a survey to analyze caseload and measures to adapt indications for a perception of crisis.
METHODS
We constructed a questionnaire to survey a snapshot of neurosurgical activity, resources, and indications during 1 week with usual activity in December 2019 and 1 week during SARS-CoV-2 pandemic in March 2020. The questionnaire was sent to 34 neurosurgical departments in Europe; 25 departments returned responses within 5 days.
RESULTS
We found unexpectedly large differences in resources and indications already before the pandemic. Differences were also large in how much practice and resources changed during the pandemic. Neurosurgical beds and neuro-intensive care beds were significantly decreased from December 2019 to March 2020. The utilization of resources decreased via less demand for care of brain injuries and subarachnoid hemorrhage, postponing surgery and changed surgical indications as a method of rationing resources. Twenty departments (80%) reduced activity extensively, and the same proportion stated that they were no longer able to provide care according to legitimate medical needs.
CONCLUSION
Neurosurgical centers responded swiftly and effectively to a sudden decrease of neurosurgical capacity due to relocation of resources to pandemic care. The pandemic led to rationing of neurosurgical care in 80% of responding centers. We saw a relation between resources before the pandemic and ability to uphold neurosurgical services. The observation of extensive differences of available beds provided an opportunity to show how resources that had been restricted already under normal conditions translated to rationing of care that may not be acceptable to the public of seemingly affluent European countries.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or Covid-19), which began as an epidemic in China and spread globally as a pandemic, has necessitated resource management to meet emergency needs of Covid-19 patients and other emergent cases. We have conducted a survey to analyze caseload and measures to adapt indications for a perception of crisis.
METHODS
We constructed a questionnaire to survey a snapshot of neurosurgical activity, resources, and indications during 1 week with usual activity in December 2019 and 1 week during SARS-CoV-2 pandemic in March 2020. The questionnaire was sent to 34 neurosurgical departments in Europe; 25 departments returned responses within 5 days.
RESULTS
We found unexpectedly large differences in resources and indications already before the pandemic. Differences were also large in how much practice and resources changed during the pandemic. Neurosurgical beds and neuro-intensive care beds were significantly decreased from December 2019 to March 2020. The utilization of resources decreased via less demand for care of brain injuries and subarachnoid hemorrhage, postponing surgery and changed surgical indications as a method of rationing resources. Twenty departments (80%) reduced activity extensively, and the same proportion stated that they were no longer able to provide care according to legitimate medical needs.
CONCLUSION
Neurosurgical centers responded swiftly and effectively to a sudden decrease of neurosurgical capacity due to relocation of resources to pandemic care. The pandemic led to rationing of neurosurgical care in 80% of responding centers. We saw a relation between resources before the pandemic and ability to uphold neurosurgical services. The observation of extensive differences of available beds provided an opportunity to show how resources that had been restricted already under normal conditions translated to rationing of care that may not be acceptable to the public of seemingly affluent European countries.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1007/s00701-020-04482-8
- PMID 32642834
- Persistent URL
- https://sonar.ch/global/documents/76507
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