Evidence map›Paper›PMID 34400327›Full record

ArticleWorld neurosurgery2021

Impact of COVID-19 on Neurosurgery in Brazil's Health System: The Reality of a Developing Country Affected by the Pandemic.

Leonardo J M de Macêdo Filho, Ana Carolina A Aragão, Vito Thayson D Dos Santos, Lívia B A Galvão, Nathan A Shlobin, Gaetano De Biase, Paola Suarez-Meade, Joao Paulo C Almeida, Alfredo Quinones-Hinojosa, Lucas A F de Albuquerque

Open access · greenAbstract read
In one paragraph

Article in World neurosurgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.0field-weighted citation impact, top 21% of its field
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

5 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
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  5. Important role of acute care surgery during pandemic time.World journal of gastrointestinal surgery · 2022
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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

10 authors at 5 institutions in 3 countries.

Leonardo J M de Macêdo FilhoDepartment of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, USA; Health Science Center, University of Fortaleza, Fortaleza, Ceará, Brazil. Electronic address: demacedofilho.leonardo@mayo.edu.
Ana Carolina A AragãoHealth Science Center, University of Fortaleza, Fortaleza, Ceará, Brazil.
Vito Thayson D Dos SantosHealth Science Center, University of Fortaleza, Fortaleza, Ceará, Brazil.
Lívia B A GalvãoHealth Science Center, University of Fortaleza, Fortaleza, Ceará, Brazil.
Nathan A ShlobinFeinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Gaetano De BiaseDepartment of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, USA.
Paola Suarez-MeadeDepartment of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, USA.
Joao Paulo C AlmeidaDivision of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
Alfredo Quinones-HinojosaDepartment of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, USA.
Lucas A F de AlbuquerqueDepartment of Neurosurgery, General Hospital of Fortaleza, Fortaleza, Ceará, Brazil.
Jacksonville College · USUniversidade de Fortaleza · BRHospital Geral de Fortaleza · BRNorthwestern University · USUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe coronavirus disease identified in 2019 (COVID-19) pandemic changed neurosurgery protocols to provide ongoing care for patients while ensuring the safety of health care workers. In Brazil, the rapid spread of the disease led to new challenges in the health system. Neurooncology practice was one of the most affected by the pandemic due to restricted elective procedures and new triage protocols. We aim to characterize the impact of the pandemic on neurosurgery in Brazil.

methodsWe analyzed 112 different types of neurosurgical procedures, with special detail in 11 neurooncology procedures, listed in the Brazilian Hospital Information System records in the DATASUS database between February and July 2019 and the same period in 2020. Linear regression and paired t-test analyses were performed and considered statistically significant at P < 0.05.

resultsThere was an overall decrease of 21.5% (28,858 cases) in all neurosurgical procedures, impacting patients needing elective procedures (-42.46%) more than emergency surgery (-5.93%). Neurooncology procedures decreased by 14.89%. Nonetheless, the mortality rate during hospitalization increased by 21.26%. Linear regression analysis in hospitalizations (Slope = 0.9912 ± 0.07431; CI [95%] = 0.8231-1.159) and total cost (Slope = 1.03 ± 0.03501; CI [95%] = 0.9511-1.109) in the 11 different types of neurooncology procedures showed a P < 0.0001. The mean cost per type of procedure showed an 11.59% increase (P = 0.0172) between 2019 and 2020.

conclusionsThe COVID-19 pandemic has increased mortality, decreased hospitalizations, and therefore decreased overall costs, despite increased costs per procedure for a variety of neurosurgical procedures. Our study serves as a stark example of the effect of the pandemic on neurosurgical care in settings of limited resources and access to care.

Indexed as

Developing CountriesBrazilCOVID-19Delivery of Health CareHealth PersonnelHospital Information SystemsHumansNeurosurgical ProceduresPersonal Protective EquipmentCOVID-19Developing countriesNeurosurgerySocioeconomic factors

Identifiers

PMID34400327
PMCPMC8548285
OpenAlexW3193929993

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.