Evidence map›Paper›PMID 33905912›Full record

Observational studyWorld neurosurgery2021

Demand for Essential Nonambulatory Neurosurgical Care Decreased While Acuity of Care Increased During the Coronavirus Disease 2019 (COVID-19) Surge.

Belinda Shao, Oliver Y Tang, Owen P Leary, Hael Abdulrazeq, Rahul A Sastry, Sarah Brown, Ira B Wilson, Wael F Asaad, Ziya L Gokaslan

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in World neurosurgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Belinda ShaoDepartment of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA. Electronic address: belinda_shao@brown.edu.
Oliver Y TangDepartment of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA.
Owen P LearyDepartment of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA.
Hael AbdulrazeqDepartment of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA.
Rahul A SastryDepartment of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA.
Sarah BrownDepartment of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA.
Ira B WilsonDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Wael F AsaadDepartment of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA.
Ziya L GokaslanDepartment of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA.

Funding

Translational ScienceP30AI042853 · NIAID · MIRIAM HOSPITAL · PI CURT G BECKWITH · 1998 to 2026
$51.7M
Tracking and Evaluation CoreU54GM115677 · NIGMS · BROWN UNIVERSITY · PI ROUNDS, SHARON IRENE SMITH · 2016 to 2025
$45.0M
NIAID NIH HHS P30 AI042853NIGMS NIH HHS U54 GM115677
6 · The paper itself

Abstract

backgroundIn times of health resource reallocation, capacities must remain able to meet a continued demand for essential, nonambulatory neurosurgical acute care. This study sought to characterize the demand for and provision of neurosurgical acute care during the coronavirus disease 2019 (COVID-19) pandemic.

methodsThis single-center cross-sectional observational analysis compared nonambulatory neurosurgical consult encounters during the peri-surge period (March 9 to May 31, 2020) with those during an analogous period in 2019. Outcomes included consult volume, distribution of problem types, disease severity, and rate of acute operative intervention.

resultsA total of 1494 neurosurgical consults were analyzed. Amidst the pandemic surge, 583 consults were seen, which was 6.4 standard deviations below the mean among analogous 2016-2019 periods (mean 873; standard deviation 45, P = 0.001). Between 2019 and 2020, the proportion of degenerative spine consults decreased in favor of spinal trauma (25.6% vs. 34% and 51.9% vs. 41.4%, P = 0.088). Among aneurysmal subarachnoid hemorrhage cases, poor-grade (Hunt and Hess grades 4-5) presentations were more common (30% vs. 14.8%, P = 0.086). A greater proportion of pandemic era consults resulted in acute operative management, with an unchanged absolute frequency of acutely operative consults (123/583 [21.1%] vs. 120/911 [13.2%], P < 0.001).

conclusionsNeurosurgical consult volume during the pandemic surge hit a 5-year institutional low. Amidst vast reallocation of health care resources, demand for high-acuity nonambulatory neurosurgical care continued and proportionally increased for greater-acuity pathologies. In our continued current pandemic as well as any future situations of mass health resource reallocation, neurosurgical acute care capacities must be preserved.

Indexed as

Patient AcuityAdultAgedCohort StudiesCOVID-19Cross-Sectional StudiesFemaleHealth ResourcesHealth Services Needs and DemandHumansMaleMiddle AgedNervous System DiseasesNeurosurgical ProceduresAcute care neurosurgeryCOVID-19 surgePandemic preparednessPublic health

Identifiers

PMID33905912
PMCPMC8589108

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.