Evidence map›Paper›PMID 35724884›Full record

ArticleWorld neurosurgery2022

Neurosurgery Subspecialty Practice During a Pandemic: A Multicenter Analysis of Operative Practice in 7 U.S. Neurosurgery Departments During Coronavirus Disease 2019.

Dimitri Benner, Benjamin K Hendricks, Cyrus Elahi, Michael D White, Gary Kocharian, Leonardo E Albertini Sanchez, Kyle E Zappi, Andrew L A Garton, Joseph A Carnevale, Theodore H Schwartz and 14 more

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

Article in World neurosurgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Observational
  3. 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

24 authors.

Dimitri BennerDepartment of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Benjamin K HendricksDepartment of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Cyrus ElahiDepartment of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Michael D WhiteDepartment of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Gary KocharianDepartment of Neurosurgery, New York-Presbyterian Hospital at Weill Cornell Medicine, New York, New York, USA.
Leonardo E Albertini SanchezDepartment of Neurosurgery, New York-Presbyterian Hospital at Weill Cornell Medicine, New York, New York, USA.
Kyle E ZappiDepartment of Neurosurgery, New York-Presbyterian Hospital at Weill Cornell Medicine, New York, New York, USA.
Andrew L A GartonDepartment of Neurosurgery, New York-Presbyterian Hospital at Weill Cornell Medicine, New York, New York, USA.
Joseph A CarnevaleDepartment of Neurosurgery, New York-Presbyterian Hospital at Weill Cornell Medicine, New York, New York, USA.
Theodore H SchwartzDepartment of Neurosurgery, New York-Presbyterian Hospital at Weill Cornell Medicine, New York, New York, USA.
Ehsan DowlatiDepartment of Neurosurgery, Georgetown University, Washington, DC, USA.
Daniel R FelbaumDepartment of Neurosurgery, Georgetown University, Washington, DC, USA.
Kenneth D SackDepartment of Neurosurgery, The George Washington University, Washington, DC, USA.
Walter C JeanDepartment of Neurosurgery, The George Washington University, Washington, DC, USA.
Andrew K ChanDepartment of Neurosurgery, University of California, San Francisco, San Francisco, California, USA.
John F BurkeDepartment of Neurosurgery, University of California, San Francisco, San Francisco, California, USA.
Praveen V MummaneniDepartment of Neurosurgery, University of California, San Francisco, San Francisco, California, USA.
Michael J StrongDepartment of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
Timothy J YeeDepartment of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
Mark E OppenlanderDepartment of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
Mariam IshaqueDepartment of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA.
Mark E ShaffreyDepartment of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA.
Hasan R SyedDepartment of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA.
Michael T LawtonDepartment of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA. Electronic address: neuropub@barrowneuro.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveChanges to neurosurgical practices during the coronavirus disease 2019 (COVID-19) pandemic have not been thoroughly analyzed. We report the effects of operative restrictions imposed under variable local COVID-19 infection rates and health care policies using a retrospective multicenter cohort study and highlight shifts in operative volumes and subspecialty practice.

methodsSeven academic neurosurgery departments' neurosurgical case logs were collected; procedures in April 2020 (COVID-19 surge) and April 2019 (historical control) were analyzed overall and by 6 subspecialties. Patient acuity, surgical scheduling policies, and local surge levels were assessed.

resultsOperative volume during the COVID-19 surge decreased 58.5% from the previous year (602 vs. 1449, P = 0.001). COVID-19 infection rates within departments' counties correlated with decreased operative volume (r = 0.695, P = 0.04) and increased patient categorical acuity (P = 0.001). Spine procedure volume decreased by 63.9% (220 vs. 609, P = 0.002), for a significantly smaller proportion of overall practice during the COVID-19 surge (36.5%) versus the control period (42.0%) (P = 0.02). Vascular volume decreased by 39.5% (72 vs. 119, P = 0.01) but increased as a percentage of caseload (8.2% in 2019 vs. 12.0% in 2020, P = 0.04). Neuro-oncology procedure volume decreased by 45.5% (174 vs. 318, P = 0.04) but maintained a consistent proportion of all neurosurgeries (28.9% in 2020 vs. 21.9% in 2019, P = 0.09). Functional neurosurgery volume, which declined by 81.4% (41 vs. 220, P = 0.008), represented only 6.8% of cases during the pandemic versus 15.2% in 2019 (P = 0.02).

conclusionsOperative restrictions during the COVID-19 surge led to distinct shifts in neurosurgical practice, and local infective burden played a significant role in operative volume and patient acuity.

Indexed as

COVID-19NeurosurgeryCohort StudiesHumansNeurosurgical ProceduresPandemicsAcuityCOVID-19EpidemiologyMulticenterNeurosurgical subspecialty practicePandemic

Identifiers

PMID35724884
PMCPMC9212868

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.