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Richardson GE, Islim AI, Albanese E, Ahmed A, Aly A, Ammar A, Amoo M, Bhatt H, Bodkin P, Coulter I, Corr P, Elmaadawi I, Elserius A, Fountain DM, George KJ, Gillespie CS, Goel A, Grundy PL, Gurusinghe N, Hartley J, Hasan MT, Javadpour M, Kalra N, Mallucci C, Millward CP, Mohamed B, Mohamed S, Mustafa MA, Nannapaneni R, Nolan D, Patel UJ, Piper RJ, Rajaraman C, Raza-Knight S, Rehman K, Rominiyi O, Sage W, Sharouf F, Sinha S, Sitaraman M, Smith S, Solth A, Stokes S, Taweel BA, Tyagi A, Zaben M, Jenkinson MD, Prasad M. Neurosurgery activity levels in the United Kingdom and republic of Ireland during the first wave of the covid-19 pandemic - a retrospective cross-sectional cohort study. Br J Neurosurg 2024; 38:998-1003. [PMID: 34472417 DOI: 10.1080/02688697.2021.1968341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/11/2021] [Accepted: 08/09/2021] [Indexed: 12/27/2022]
Abstract
The impact of Covid-19 on surgical patients worldwide has been substantial. In the United Kingdom (UK) and the Republic of Ireland (RoI), the first wave of the pandemic occurred in March 2020. The aims of this study were to: (1) evaluate the volume of neurosurgical operative activity levels, Covid-19 infection rate and mortality rate in April 2020 with a retrospective cross-sectional cohort study conducted across 16 UK and RoI neurosurgical centres, and (2) compare patient outcomes in a single institution in April-June 2020 with a comparative cohort in 2019. Across the UK and RoI, 818 patients were included. There were 594 emergency and 224 elective operations. The incidence rate of Covid-19 infection was 2.6% (21/818). The overall mortality rate in patients with a Covid-19 infection was 28.6% (6/21). In the single centre cohort analysis, an overall reduction in neurosurgical operative activity by 65% was observed between 2020 (n = 304) and 2019 (n = 868). The current and future impact on UK neurosurgical operative activity has implications for service delivery and neurosurgical training.
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Affiliation(s)
- George E Richardson
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Abdurrahman I Islim
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Erminia Albanese
- Department of Neurosurgery, North Staffordshire Hospital Trust, Stoke on Trent, UK
| | - Ahmed Ahmed
- Department of Neurosurgery, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Ahmed Aly
- Department of Neurosurgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Amr Ammar
- Department of Neurosurgery, Queen's Medical Centre, Nottingham, UK
| | - Michael Amoo
- Department of Neurosurgery, Beaumont Hospital, Dublin, Republic of Ireland
| | - Harsh Bhatt
- Department of Neurosurgery, University Hospital of Wales, Cardiff, UK
| | - Peter Bodkin
- Department of Neurosurgery, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Ian Coulter
- Department of Neurosurgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Paula Corr
- Department of Neurosurgery, Beaumont Hospital, Dublin, Republic of Ireland
| | | | - Anne Elserius
- Department of Neurosurgery, North Staffordshire Hospital Trust, Stoke on Trent, UK
| | - Daniel M Fountain
- Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK
| | - K Joshi George
- Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK
| | - Conor S Gillespie
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Aimee Goel
- Department of Neurosurgery, North Staffordshire Hospital Trust, Stoke on Trent, UK
| | - Paul L Grundy
- Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Jessica Hartley
- Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield, UK
| | - Md Tanvir Hasan
- Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK
| | - Mohsen Javadpour
- Department of Neurosurgery, Beaumont Hospital, Dublin, Republic of Ireland
| | - Neeraj Kalra
- Department of Neurosurgery, Leeds General Infirmary, Leeds, UK
| | - Conor Mallucci
- Department of Neurosurgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Christopher P Millward
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Belal Mohamed
- Department of Neurosurgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Saffwan Mohamed
- Department of Neurosurgery, The James Cook University Hospital, Middlesbrough, UK
| | - Mohammad A Mustafa
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | | | - Deirdre Nolan
- Department of Neurosurgery, Beaumont Hospital, Dublin, Republic of Ireland
| | - Umang J Patel
- Department of Neurosurgery, John Radcliffe Hospital, Oxford, UK
| | - Rory J Piper
- Department of Neurosurgery, John Radcliffe Hospital, Oxford, UK
| | | | | | - Kafeel Rehman
- Department of Neurosurgery, Hull Royal Infirmary, Hull, UK
| | - Ola Rominiyi
- Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield, UK
| | - William Sage
- Department of Neurosurgery, Queen's Medical Centre, Nottingham, UK
| | - Feras Sharouf
- Department of Neurosurgery, University Hospital of Wales, Cardiff, UK
| | - Saurabh Sinha
- Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield, UK
| | | | - Stuart Smith
- Department of Neurosurgery, Queen's Medical Centre, Nottingham, UK
| | - Anna Solth
- Department of Neurosurgery, Ninewells Hospital, Dundee, UK
| | - Stuart Stokes
- Department of Neurosurgery, Hull Royal Infirmary, Hull, UK
| | - Basel A Taweel
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Atul Tyagi
- Department of Neurosurgery, Leeds General Infirmary, Leeds, UK
| | - Malik Zaben
- Department of Neurosurgery, University Hospital of Wales, Cardiff, UK
| | - Michael D Jenkinson
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Manjunath Prasad
- Department of Neurosurgery, The James Cook University Hospital, Middlesbrough, UK
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Farsakh A, Li S, Toomey F, Castle-Kirszbaum M, Kam J, Goldschlager T. Pituitary surgery and COVID. Pituitary 2024:10.1007/s11102-024-01423-x. [PMID: 38967764 DOI: 10.1007/s11102-024-01423-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/25/2024] [Indexed: 07/06/2024]
Abstract
An effect of the COVID-19 pandemic was the disruption of healthcare systems, especially surgical services provided to the community. Pituitary surgery was especially impacted, given the majority of cases were deemed non-urgent with very few exceptions, and the high risk of viral transmission conferred by the endoscopic endonasal transsphenoidal approach. Patients suffering from pituitary lesions with resultant endocrinopathy or visual symptoms saw their treatment delayed or altered, which had implications on their outcomes and care. This disruption extended to surgical training and the usual functioning of academic units, necessitating changes to curricula and implementation of novel methods of progressing surgical education. This review will explore the effect of the COVID pandemic on pituitary surgery, the experiences of various surgeons as well as the adaptations implemented on the frontlines. The lessons learned from the experience of the pandemic may assist specialists in gleaning insights regarding the care of patients in the future.
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Affiliation(s)
- Ameen Farsakh
- Department of Neurosurgery, Monash Medical Centre, Monash Health, Melbourne, Australia.
| | - Sandra Li
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Fidel Toomey
- Department of Neurosurgery, Monash Medical Centre, Monash Health, Melbourne, Australia
| | - Mendel Castle-Kirszbaum
- Department of Neurosurgery, Monash Medical Centre, Monash Health, Melbourne, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Jeremy Kam
- Department of Neurosurgery, Monash Medical Centre, Monash Health, Melbourne, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Tony Goldschlager
- Department of Neurosurgery, Monash Medical Centre, Monash Health, Melbourne, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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Islam MT, Bruce M, Alam K. Patterns and determinants of healthcare utilization and medication use before and during the COVID-19 crisis in Afghanistan, Bangladesh, and India. BMC Health Serv Res 2024; 24:416. [PMID: 38570763 PMCID: PMC10988829 DOI: 10.1186/s12913-024-10789-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 02/27/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND COVID-19 rapidly spread through South Asian countries and overwhelmed the health systems that were unprepared for such an outbreak. Evidence from high-income countries showed that COVID-19 impacted healthcare utilization, including medication use, but empirical evidence is lacking in South Asia. This study aimed to investigate the effect of COVID-19 on healthcare utilization and medication use in South Asia. METHOD The current study used longitudinal data from the 'Premise Health Service Disruption Survey' 2020 and 2021. The countries of interest were limited to Afghanistan, Bangladesh, and India. In these surveys, data related to healthcare utilization and medication use were collected for three-time points; 'Pre-COVID phase', 'Initial phase of COVID-19 outbreak', and 'One year of COVID-19 outbreak'. Generalized estimating equation (GEE) along with McNemar's test, Kruskal-Wallis test and χ2 test were applied in this study following the conceptualization of Andersen's healthcare utilization model. RESULT The use of healthcare and medication was unevenly impacted by the COVID-19 epidemic in Afghanistan, Bangladesh, and India. Immediately after the COVID-19 outbreak, respondents in Bangladesh reported around four times higher incomplete healthcare utilization compared to pre-COVID phase. In contrast, respondents in Afghanistan reported lower incomplete utilization of healthcare in a similar context. In the post COVID-19 outbreak, non-adherence to medication use was significantly higher in Afghanistan (OR:1.7; 95%CI:1.6,1.9) and India (OR:1.3; 95%CI:1.1,1.7) compared to pre-COVID phase. Respondents of all three countries who sought assistance to manage non-communicable diseases (NCDs) had higher odds (Afghanistan: OR:1.5; 95%CI:1.3,1.8; Bangladesh: OR: 3.7; 95%CI:1.9,7.3; India: OR: 2.3; 95% CI: 1.4,3.6) of non-adherence to medication use after the COVID-19 outbreak compared to pre-COVID phase. CONCLUSION The present study documented important evidence of the influence of COVID-19 epidemic on healthcare utilization and medication use in three countries of South Asia. Lessons learned from this study can feed into policy responses to the crisis and preparedness for future pandemics.
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Affiliation(s)
- Md Tauhidul Islam
- Murdoch Business School, Murdoch University, 6150, Perth, WA, Australia.
| | - Mieghan Bruce
- School of Veterinary Medicine and Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, 6150, Perth, WA, Australia
| | - Khurshid Alam
- Murdoch Business School, Murdoch University, 6150, Perth, WA, Australia
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Axenhus M, Schedin-Weiss S, Tjernberg L, Winblad B. The impact of the COVID-19 pandemic on neurosurgery in the elderly population in Sweden. BMC Public Health 2024; 24:823. [PMID: 38491396 PMCID: PMC10941451 DOI: 10.1186/s12889-024-18332-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 03/12/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic prompted a refocus of health care resources to acute care which has impacted on the capacity of healthcare systems to conduct neurological surgeries. The elderly population has been shown to be particularly vulnerable to the consequences of the pandemic. Less neurosurgery can result in great impact on public health by increasing morbidity and mortality in patients with malignancies and traumatic injuries. The aim of this study was to investigate the effects of the COVID-19 pandemic on neurosurgical procedures in the elderly population in Sweden. METHODS In this retrospective observational study, the reported incidence of all neurosurgical procedures registered in the 21 Regions of Sweden during 2015-2021 in people aged 65 year or older was collected. Surgical procedures were classified according to the NOMESCO system of classification. Neurosurgery incidence was defined as the number of NOMESCO associated interventions per 100.000 inhabitants. ICD-10 codes associated with neurosurgery-related diagnoses and deaths were also collected. Expected incidence of neurosurgery, neurosurgery-associated deaths and brain cancer diagnoses was estimated and compared to actual outcomes. Decrease in the incidence of neurosurgery was compared to regional COVID-19 incidence, other types of surgery and surgery waiting times. RESULTS The incidence of several categories of neurosurgery decreased in Sweden during 2020 and 2021, although not as much as other surgical categories. Women were more affected than men by the decrease in neurosurgery which could be partly explained by a decrease in brain cancer diagnoses amongst women. There was an association between regional decrease in neurosurgery incidence and longer surgery waiting time. COVID-19 incidence in the region did not have an effect on regional decreases in neurosurgery incidence. CONCLUSIONS The COVID-19 pandemic resulted in a reduction in the number of neurosurgical procedures performed in Sweden during 2020-2021, although not as much as in other European countries. There was regional difference in Sweden with respect to number of surgeries, and waiting time for elective surgeries although there was no increase in mortality.
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Affiliation(s)
- Michael Axenhus
- Department of Clinical Sciences at Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
| | - Sophia Schedin-Weiss
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lars Tjernberg
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Bengt Winblad
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University hospital, Huddinge, Sweden
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Kumarapuram S, Sreenivasan S, Mathivanan A, Manchiraju P, Khuroo M, Sundararajan S, Nanda A, Roychowdhury S, Gupta G. Network analysis of neurosurgical literature: an increased focus on training during the COVID-19 pandemic. Neurosurg Rev 2023; 46:178. [PMID: 37466764 DOI: 10.1007/s10143-023-02069-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/10/2023] [Accepted: 06/20/2023] [Indexed: 07/20/2023]
Abstract
The COVID-19 pandemic led to stringent guidelines to restrict the conduct of non-emergent surgical procedures. Consequently, neurosurgery departments experienced a decline in case volumes and greater educational time being spent on virtual research projects. In our report, we reveal how neurosurgical research has changed during the pandemic compared to the pre-pandemic phase. The WebOfScience database was searched for neurosurgical articles published between 2012-2019 (pre-pandemic) and 2020-2022 (pandemic). From this data, the keywords, terms, and countries were analyzed using networks formed by the VOS Viewer software. In addition, the analysis was repeated for neurosurgical articles specific to COVID-19. Network analyses of terms and keywords revealed an increased popularity of virtual research projects, including case reports, meta-analyses, reviews, surveys, and database studies. Additionally, there was increased interest in research pertaining to neurosurgical education during the post-pandemic era, including topics regarding virtual training modalities, mental health, and telemedicine. Our bibliometrics analysis suggests that the impact of COVID-19 restrictions on hospital systems affected neurosurgical training programs. Future investigations should explore the effects of the trainee experience during the COVID-19 pandemic on the outlook for neurosurgical education.
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Affiliation(s)
- Siddhant Kumarapuram
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA
| | - Sanjeev Sreenivasan
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA
| | - Akanksha Mathivanan
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA
| | - Pranav Manchiraju
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA
| | - Mohammad Khuroo
- Department of Neurosurgery, Rice University, Houston, TX, USA
| | - Srihari Sundararajan
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA
| | - Anil Nanda
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA
| | - Sudipta Roychowdhury
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA
| | - Gaurav Gupta
- Department of Neurosurgery, Robert Wood Johnson Medical School, RUTGERS University, New Brunswick, NJ, USA.
- Rutgers RWJ Barnabas Healthcare System, Rutgers Robert Wood Johnson Medical School, 10 Plum Street, 5th floor, # 548, New Brunswick, NJ, 08903-2601, USA.
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Upadhyay S, Flora R, Rajaee A, Ugiliweneza B, Iles AM. Training of Family Medicine residents in the first year of the COVID-19 pandemic. J Family Med Prim Care 2023; 12:996-1002. [PMID: 37448918 PMCID: PMC10336927 DOI: 10.4103/jfmpc.jfmpc_1777_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/29/2023] [Accepted: 02/06/2023] [Indexed: 07/18/2023] Open
Abstract
Background The immediate impact of the pandemic on resident training has been well documented. As the pandemic and its effects persisted beyond what was initially predicted, this study aimed to assess the impact of the pandemic on the training of family medicine (FM) residents a year after it began and to assess the burnout residents experienced during this period. Methods The survey was conducted between January 18 and February 18, 2021. Participation was solicited via an email sent to the program directors throughout the US, who were asked to circulate the survey among their residents. The questionnaire was divided into sections to assess the impact of the pandemic on clinical training, didactics, and preparedness for the next phase in the career. In addition, the burnout experienced was assessed using the Copenhagen Burnout Inventory. Results 227 responses were analyzed. 83% (n = 186) of respondents felt that the pandemic had a negative impact on their training and 63% (n = 141) felt that the pandemic had a negative impact on didactics. 50% (n = 44) of the third-year residents thought that they would be able to meet the graduation requirement for outpatient encounters. 41% (n = 36) of the third-year residents felt less prepared for the next step in their careers. 119 respondents met the cutoff threshold for personal burnout, 134 for work-related burnout, and 65 for client-related burnout. Conclusion Residency training is difficult with high reported rates of burnout before the COVID-19 pandemic. This study reinforces the evidence that the pandemic made both mental well-being and adequate training more difficult for FM residents across the country.
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Affiliation(s)
- Smita Upadhyay
- Department of Family and Geriatric Medicine, University of Louisville, Louisville, KY, USA
| | - Rebecca Flora
- Department of Family and Geriatric Medicine, University of Louisville, Louisville, KY, USA
| | - Arezoo Rajaee
- Department of Family and Geriatric Medicine, University of Louisville, Louisville, KY, USA
| | - Beatrice Ugiliweneza
- Department of Neurosurgery, University of Louisville, Louisville, KY, USA
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, USA
- Department of Health Management and Systems Sciences, University of Louisville, Louisville, KY, USA
| | - Ashley M. Iles
- Department of Family and Geriatric Medicine, University of Louisville, Louisville, KY, USA
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Karimov Z, Ozgiray E. The Effect of COVID-19 in a University Hospital Neurosurgery Clinic Comparison to Prepandemic Period: A Retrospective Study with 6 months of Data. World Neurosurg 2023; 173:e616-e621. [PMID: 36870446 PMCID: PMC9981517 DOI: 10.1016/j.wneu.2023.02.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic affected all countries' health systems and people's lifestyles. In this study, we aimed to investigate its effects in a university hospital neurosurgery clinic. METHODS The 2019 year's 6 months' data as a prepandemic period compared to the 2020 year's same period as a pandemic date. Demographic data were collected. Operations were divided into seven groups: tumor, spinal, vascular, cerebrospinal fluid disorders, hematoma, local, and minor surgery, respectively. We classified the hematoma cluster into subgroups to evaluate the etiology: epidural, acute subdural, subarachnoid hemorrhage, intracerebral hemorrhage, depressed skull fractures, and others. Patients' COVID-19 test results were collected. RESULTS Total operations decreased from 972 to 795 (Δ18.2%) during the pandemic. All groups, except minor surgery cases, decreased compared to the prepandemic period. Also, vascular procedures for females increased during the pandemic period. While focusing on the hematoma subgroups, there was decreasing in epidural and subdural hematomas, depressed skull fractures, and total case numbers; an increase in subarachnoid hemorrhage and intracerebral hemorrhage. Overall mortality significantly increased to 9.6% from 6.8% during the pandemic (P = 0.033). Eight (1.0%) of 795 patients were COVID-19-positive; three of them died. Neurosurgery residents and academicians were unsatisfied with decreased number of operations, training, and research productivity. CONCLUSIONS The pandemic and restrictions affected negatively the health system and people's access to healthcare. Our retrospective observational study aimed to evaluate these effects and take lessons for the next similar situations. People's access to health care should be considered when lockdown restrictions.
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Affiliation(s)
- Ziya Karimov
- Medicine Program, Ege University Faculty of Medicine, Izmir, Turkiye.
| | - Erkin Ozgiray
- Department of Neurosurgery, Ege University Faculty of Medicine, Izmir, Turkiye
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Dokponou YCH, Nyalundja AD, Madjoue ADO, Dossou MW, Badirou O, Agada N, Lasssissi K, adjovi FM, Lawson LD, Bankole NDA. COVID-19 impact on the global neurosurgery resident training course and admission: A scoping review. Surg Neurol Int 2023; 14:96. [PMID: 37025540 PMCID: PMC10070250 DOI: 10.25259/sni_68_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/01/2023] [Indexed: 04/08/2023] Open
Abstract
Background This study looks at how COVID-19 affected the admission and training of neurosurgical residents worldwide. Methods From 2019 to 2021, we reviewed multiple databases (i.e., Google Scholar, Science Direct, PubMed, and Hinari) to evaluate the impact of the COVID-19 pandemic on neurosurgery resident training and admission in low middle-income countries (LMICs) and high-income countries (HICs). We then utilized a Wilcoxon signed-rank test to evaluate the difference between the two LMIC/HICs and employed Levene's test to assess the homogeneity of variances. Results There were 58 studies that met our inclusion criteria; 48 (72.4%) were conducted in HIC and 16 (27.6%) in LMIC. The admission of new residents was mostly canceled in HIC (31.7%; n = 13) and in LMIC (25%; n = 4) from 2019 to 2021 due to COVID-19. Learning modalities changed to include predominantly video conferencing (i.e., 94.7% [n = 54] of cases). Further, neurosurgery was largely restricted to emergency cases alone (79.6% [n = 39]), with only 12.2% (n = 6) elective cases. The result was a marked reduction in resident surgical training (i.e., 66.7% [n = 10] in LMIC and 62.9% [n = 22] in HIC), despite increased workloads in (i.e., LMIC [37.4%; n = 6] and HIC [35.7%; n = 15]). This was attributed to the marked reduction in the number of surgical patients allotted to each resident (i.e., LMIC [87.5%; n = 14] than HIC [83.3%; n = 35]). Conclusion The COVID-19 pandemic markedly disrupted neurosurgical education globally. Although differences have been found between LMICs and HICs training, the reduction of neurosurgical case-loads and surgical procedures has significantly impacted neurosurgical training. The question remains, how can this "loss of experience" be redressed in the future?
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Affiliation(s)
| | - Arsene Daniel Nyalundja
- Department of Neurosurgery, Faculté de Médecine, Université Catholique de Bukavu, Democratic Republic of Congo, Université Catholique de Bukavu, South-Kivu, Democratic Republic of the Congo
| | | | - Mèhomè Wilfried Dossou
- Department of Research, Sub-Saharan Africa Future Neurosurgeon Association, Cotonou, Benin
| | - Omar Badirou
- Department of Research, Sub-Saharan Africa Future Neurosurgeon Association, Cotonou, Benin
| | - Nicaise Agada
- Department of Research, Sub-Saharan Africa Future Neurosurgeon Association, Cotonou, Benin
| | - Katib Lasssissi
- Department of Research, Sub-Saharan Africa Future Neurosurgeon Association, Cotonou, Benin
| | - Fritzell Marc adjovi
- Department of Research, Sub-Saharan Africa Future Neurosurgeon Association, Cotonou, Benin
| | - Laté dzidoula Lawson
- Department of Research, Sub-Saharan Africa Future Neurosurgeon Association, Cotonou, Benin
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Kuo CC, Aguirre AO, Kassay A, Donnelly BM, Bakr H, Aly M, Ezzat AA, Soliman MA. A look at the global impact of COVID-19 pandemic on neurosurgical services and residency training. SCIENTIFIC AFRICAN 2023; 19:e01504. [PMID: 36531434 PMCID: PMC9747235 DOI: 10.1016/j.sciaf.2022.e01504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/18/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
Background The COVID-19 pandemic has left an indelible effect on healthcare delivery and education system, including residency training. Particularly, neurosurgical departments worldwide had to adapt their operating model to the constantly changing pandemic landscape. This review aimed to quantify the reduction in neurosurgical operative volume and describe the impact of these trends on neurosurgical residency training. Methods We performed a comprehensive search of PubMed and EMBASE between December 2019 and October 2022 to identify studies comparing pre-pandemic and pandemic neurosurgical caseloads as well as articles detailing the impact of COVID-19 on neurosurgery residency training. Statistical analysis of quantitative data was presented as pooled odds ratio (OR) and 95% confidence intervals (CI). Results A total of 49 studies met the inclusion criteria, of which 12 (24.5%) were survey-based. The case volume of elective surgeries and non-elective procedures decreased by 70.4% (OR=0.296, 95%CI 0.210-0.418) and 68.2% (OR=0.318, 95%CI 0.193-0.525), respectively. A significant decrease was also observed in functional (OR=0.542, 95%CI 0.394-0.746), spine (OR=0.545, 95%CI 0.409-0.725), and skull base surgery (OR=0.545, 95%CI 0.409-0.725), whereas the caseloads for tumor (OR=1.029, 95%CI 0.838-1.263), trauma (OR=1.021, 95%CI 0.846-1.232), vascular (OR=1.001, 95%CI 0.870-1.152), and pediatric neurosurgery (OR=0.589, 95%CI 0.344-1.010) remained relatively the same between pre-pandemic and pandemic periods. The reduction in caseloads had caused concerns among residents and program directors in regard to the diminished clinical exposure, financial constraints, and mental well-being. Some positives highlighted were rapid adaptation to virtual educational platforms and increasing time for self-learning and research activities. Conclusion While COVID-19 has brought about significant disruptions in neurosurgical practice and training, this unprecedented challenge has opened the door for technological advances and collaboration that broaden the accessibility of resources and reduce the worldwide gap in neurosurgical education.
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Affiliation(s)
- Cathleen C. Kuo
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA
| | - Alexander O. Aguirre
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA
| | - Andrea Kassay
- Department of Neurosurgery, Western University, Windsor, Canada
| | - Brianna M. Donnelly
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY, USA
| | | | - Mohamed Aly
- Department of Radiology, National Heart Institute, Giza, Egypt
| | - Ahmed A.M. Ezzat
- Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed A.R. Soliman
- Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt,Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA,Corresponding author at: Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
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10
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Mann S, Duffy J, Muffly T, Tilva K, Gray S, Hetzler L, Kraft S, Malekzadeh S, Pletcher S, Cabrera-Muffly C. Effect of the COVID-19 Pandemic on Otolaryngology Trainee Surgical Case Numbers: A Multi-institutional Review. Otolaryngol Head Neck Surg 2023; 168:26-31. [PMID: 35290132 PMCID: PMC9880741 DOI: 10.1177/01945998221083845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/10/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To determine the effect of the initiation of COVID-19-related restrictions on the volume of surgical cases performed by otolaryngology trainees. STUDY DESIGN Multi-institutional retrospective analysis of resident surgical case logs. SETTING Accredited residency training programs in otolaryngology head and neck surgery. METHODS Resident surgical case logs were combined from 6 residency training programs from different regions of the United States. Case volumes were compared between the calendar year before March 1, 2020, and the year afterward. Subgroup analyses were performed for the type of hospital (university, pediatric, veteran, county) and the key index cases by subspecialty. RESULTS All 6 participating residency programs had a decrease in resident operative case volume. Surgical volume decreased from a mean of 6014 to 4161 (P < .05). There were decreases observed in key index cases in every subspecialty (P < .01), without statistical differences seen among subspecialties. There were decreases observed in every hospital type (university, pediatric, veteran, county) without statistical differences among types. Postgraduate year 5 residents were the most affected by volume reductions (51.6%), and postgraduate year 3 residents were the least affected (1.4%). CONCLUSION In the year following initiation of COVID-19-related restrictions, there was a significant decrease in trainee surgical case volumes within residencies for otolaryngology-head and neck surgery. There were no statistical differences in the volume decreases seen at different institutions, among hospital types, or within various subspecialties.
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Affiliation(s)
- Scott Mann
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Division of Otolaryngology-Head and Neck Surgery, Denver Health Hospital Authority, Denver, Colorado, USA
| | - James Duffy
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Tyler Muffly
- Department of Obstetrics and Gynecology, Denver Health Hospital Authority, Denver, Colorado, USA
| | - Keval Tilva
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Stacey Gray
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Laura Hetzler
- Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Shannon Kraft
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Health System, Kansas City, Kansas, USA
| | - Sonya Malekzadeh
- Department of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Steven Pletcher
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, USA
| | - Cristina Cabrera-Muffly
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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11
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Desai VR, Grossen A, Vuong HG, Hopkins N, Peters M, Jea A. Academic productivity in pediatric neurosurgery in relation to elective surgery slowdown during the COVID-19 pandemic. J Neurosurg Pediatr 2022; 30:525-531. [PMID: 36029266 DOI: 10.3171/2022.7.peds22173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/20/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE COVID-19 has not only impacted healthcare systems directly via hospitalizations and resource utilization, but also indirectly via adaptations in healthcare practice, such as the evolution of the academic environment and the rise of telemedicine and virtual education. This void in clinical responsibilities has been filled with academic productivity in various fields. In this study the authors investigate the influence of COVID-19 on the academic focus within pediatric neurosurgery. METHODS All data were obtained from the Journal of Neurosurgery: Pediatrics (JNS Peds). The number of submissions for each month from January 2017 to December 2021 was collected. Data including number of publications, publication level of evidence (LOE), and COVID-19-related articles were collected and verified. Each publication was categorized by manuscript and LOE according to adaptations from the Canadian Task Force on Periodic Health Examination. Publication groups were categorized as pre-COVID-19 (January 2017-February 2020), peri-COVID-19 (March 2020-July 2020), and post-COVID-19 (August 2020-December 2021). Statistical analysis was performed to compare pre-COVID-19, peri-COVID-19, and post-COVID-19 academic volume and quality. RESULTS During the study time period, a total of 3116 submissions and 997 publications were identified for JNS Peds. Only 2 articles specifically related to COVID-19 and its impact on pediatric neurosurgery were identified, both published in 2021. When analyzing submission volume, a statistically significant increase was seen during the shutdown relative to pre-COVID-19 and post-shutdown time periods, and a significant decrease was seen post-shutdown relative to pre-COVID-19. LOE changed significantly as well. When comparing pre-COVID-19 versus post-COVID-19 articles, a statistically significant increase was identified only in level 4 publications. When analyzing pre-COVID-19 versus post-COVID-19 (2020) and post-COVID-19 (2021), a statistically significant decrease in level 3 and increases in levels 4 and 5 were identified during post-COVID-19 (2020), with a rebound increase in level 3 and a decrease in level 5 during post-COVID-19 (2021). CONCLUSIONS There was a significant increase in manuscript submission during the initial pandemic period. However, there was no change during subsequent spikes in COVID-19-related hospitalizations. Coincident with the initial surge in academic productivity, despite steady publication volume, was an inverse decline in quality as assessed by LOE.
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12
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Joshi S, Khan M, Jelen MB, Pandit AS. Current Attitudes Toward Neuroanatomy: A Comparative Cross-Sectional Survey of Neurosurgeons from the United Kingdom and Worldwide. World Neurosurg 2022; 166:e607-e623. [PMID: 35868505 DOI: 10.1016/j.wneu.2022.07.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE How attitudes toward neuroanatomy and preferences of studying resources vary among neurosurgeons is unknown. The impact of the coronavirus disease 2019 (COVID-19) pandemic on anatomy learning habits is also yet to be elucidated. In this study, we explore these objectives, to guide the development of future neurosurgeon-tailored anatomy education and resources. METHODS This was a 2-stage, cross-sectional study design comprising a local pilot survey followed by a structured 17-item questionnaire, distributed to both neurosurgical trainees and consultants. Grade and nationality differences in sentiment agreement were statistically compared. RESULTS A total of 365 responses were received from 32 countries (overall response rate, 23.2%). Neuroanatomy is highly regarded among most neurosurgeons and takes a central role in their professional identity. Yet, 69% of neurosurgeons wanted to spend more time learning. Common study prompts included perceived operative complexity, lack of familiarity and teaching. Financial barriers and motivation were obstacles limiting neuroanatomy learning, more so among trainee neurosurgeons, with personal commitment barriers significantly varying with geographic location. Surgical relevance, accessibility, and image quality were important factors when selecting anatomy resources, with cost and up-to-datedness being important for juniors. The COVID-19 pandemic saw a shift toward virtual resources, particularly affecting United Kingdom-based trainees. CONCLUSIONS Although neuroanatomy is well regarded, barriers exist that impede further neuroanatomy learning. Neurosurgical training programs should tailor anatomy education according to the seniority and background of their residents. Furthermore, resources that are surgically relevant and accessible and are of high image quality are more likely to be better used.
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Affiliation(s)
- Shivani Joshi
- University College London Medical School, University College London, London, United Kingdom
| | - Mehdi Khan
- University College London Medical School, University College London, London, United Kingdom
| | - Maria B Jelen
- Department of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Anand S Pandit
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
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13
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Impact of COVID-19 on Intracranial Meningioma Resection: Results from California State Inpatient Database. Cancers (Basel) 2022; 14:cancers14194785. [PMID: 36230707 PMCID: PMC9563583 DOI: 10.3390/cancers14194785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/16/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary All fields of healthcare were adversely affected by the COVID-19 pandemic. In this study, we sought to understand the effects of COVID-19 on hospitalizations for intracranial meningioma resection using a large database. We compared hospitalization rates as well as hospital outcomes such as Clavien–Dindo grade IV complications, in-hospital mortality, and prolonged length of stay for intracranial meningioma resection during 2019 and 2020. Our findings showed that though hospitalization rates decreased slightly during the COVID-19 pandemic, hospital outcomes were not adversely affected. The findings of our study show that with adequate planning and preparations, better hospital outcomes could be sustained even during healthcare emergencies such as COVID-19 pandemic. Our findings assure that neurosurgery practice in the US ensured the best quality of care to their patients even during COVID-19 pandemic. Abstract Purpose: To assess the effects of COVID-19 on hospitalizations for intracranial meningioma resection using a large database. Methods: We conducted a retrospective analysis of the California State Inpatient Database (SID) 2019 and 2020. All adult (18 years or older) hospitalizations were included for the analysis. The primary outcomes were trends in hospitalization for intracranial meningioma resection between 2019 and 2020. Secondary outcomes were Clavien–Dindo grade IV complications, in-hospital mortality, and prolonged length of stay, which was defined as length of stay ≥75 percentile. Results: There were 3,173,333 and 2,866,161 hospitalizations in 2019 and 2020, respectively (relative decrease, 9.7%), of which 921 and 788 underwent intracranial meningioma resection (relative decrease, 14.4%). In 2020, there were 94,114 admissions for COVID-19 treatment. Logistic regression analysis showed that year in which intracranial meningioma resection was performed did not show significant association with Clavien–Dindo grade IV complications and in-hospital mortality (OR, 1.23, 95% CI: 0.78–1.94) and prolonged length of stay (OR, 1.05, 95% CI: 0.84–1.32). Conclusion: Our findings show that neurosurgery practice in the US successfully adapted to the unforeseen challenges posed by COVD-19 and ensured the best quality of care to the patients.
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14
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Benner D, Hendricks BK, Elahi C, White MD, Kocharian G, Albertini Sanchez LE, Zappi KE, Garton AL, Carnevale JA, Schwartz TH, Dowlati E, Felbaum DR, Sack KD, Jean WC, Chan AK, Burke JF, Mummaneni PV, Strong MJ, Yee TJ, Oppenlander ME, Ishaque M, Shaffrey ME, Syed HR, Lawton MT. Neurosurgery Subspecialty Practice During a Pandemic: A Multicenter Analysis of Operative Practice in 7 U.S. Neurosurgery Departments During Coronavirus Disease 2019. World Neurosurg 2022; 165:e242-e250. [PMID: 35724884 PMCID: PMC9212868 DOI: 10.1016/j.wneu.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Changes 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. METHODS Seven 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. RESULTS Operative 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). CONCLUSIONS Operative 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.
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Affiliation(s)
- Dimitri Benner
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Benjamin K. Hendricks
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Cyrus Elahi
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Michael D. White
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Gary Kocharian
- Department of Neurosurgery, New York-Presbyterian Hospital at Weill Cornell Medicine, New York, New York, USA
| | | | - Kyle E. Zappi
- Department of Neurosurgery, New York-Presbyterian Hospital at Weill Cornell Medicine, New York, New York, USA
| | - Andrew L.A. Garton
- Department of Neurosurgery, New York-Presbyterian Hospital at Weill Cornell Medicine, New York, New York, USA
| | - Joseph A. Carnevale
- Department of Neurosurgery, New York-Presbyterian Hospital at Weill Cornell Medicine, New York, New York, USA
| | - Theodore H. Schwartz
- Department of Neurosurgery, New York-Presbyterian Hospital at Weill Cornell Medicine, New York, New York, USA
| | - Ehsan Dowlati
- Department of Neurosurgery, Georgetown University, Washington, DC, USA
| | - Daniel R. Felbaum
- Department of Neurosurgery, Georgetown University, Washington, DC, USA
| | - Kenneth D. Sack
- Department of Neurosurgery, The George Washington University, Washington, DC, USA
| | - Walter C. Jean
- Department of Neurosurgery, The George Washington University, Washington, DC, USA
| | - Andrew K. Chan
- Department of Neurosurgery, University of California, San Francisco, San Francisco, California, USA
| | - John F. Burke
- Department of Neurosurgery, University of California, San Francisco, San Francisco, California, USA
| | - Praveen V. Mummaneni
- Department of Neurosurgery, University of California, San Francisco, San Francisco, California, USA
| | - Michael J. Strong
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Timothy J. Yee
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Mark E. Oppenlander
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Mariam Ishaque
- Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA
| | - Mark E. Shaffrey
- Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA
| | - Hasan R. Syed
- Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA
| | - Michael T. Lawton
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA,To whom correspondence should be addressed: Michael T. Lawton, M.D
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15
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Sarpong K, Fadalla T, Garba DL, Suliman M, Rolle M, Ammar A, Hussen H, Park KB. Access to training in neurosurgery (Part 1): Global perspectives and contributing factors of barriers to access. BRAIN & SPINE 2022; 2:100900. [PMID: 36248138 PMCID: PMC9560711 DOI: 10.1016/j.bas.2022.100900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/21/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022]
Abstract
Introduction Neurological disorders are one of the leading causes of death and disability adjusted life years (DALYs). Efforts have been made to increase the neurosurgical workforce in an attempt to address the global disease burden. Despite these efforts, there continues to be a shortage of neurosurgeons in both high-income countries (HICs) and low-and middle-income countries (LMICs). Research question The aim of the study was to identify the barriers to neurosurgical training in LMICs and HICs. Materials and methods We administered an electronic survey targeting medical students, neurosurgery residents, and recent neurosurgery graduates from 69 countries in both HICs and LMICs. Questions were framed to assess barriers to training. Results Of the 198 responses received (31.3% response rate), 72% identified as male, 27% female, and 0.5% as non-binary gender. 33 respondents were from HICs and 165 were from LMICs. 70.1% of respondents reported no availability of dissection labs in their home institutions. There was a significant difference in availability of subspecialty training between LMICs and HMICs (p = 0.001) but no significance was seen for competitiveness of programs (p = 0.473). Discussion and conclusion There are limitations to our study: it is not comprehensive of training programs globally, there is sampling bias, especially among LMICs, and the accuracy of responses is unclear. Nonetheless, our results highlight the need for a deliberate focus on designing and implementing both short and long term goals in tackling barriers to access to neurosurgical training, with a conscientious effort to involve interested stakeholders and governments to invest in the training and education of their neurosurgical workforce.
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Affiliation(s)
- Kwadwo Sarpong
- Georgetown University School of Medicine, Washington, DC, USA
| | - Tarig Fadalla
- Ribat NeuroSpine Center, Ribat University Hospital, The National Ribat University, Khartoum, Sudan
| | - Deen L. Garba
- Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Mazin Suliman
- Ribat NeuroSpine Center, Ribat University Hospital, The National Ribat University, Khartoum, Sudan
| | - Myron Rolle
- Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Adam Ammar
- Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Haytham Hussen
- Ribat NeuroSpine Center, Ribat University Hospital, The National Ribat University, Khartoum, Sudan
| | - Kee B. Park
- Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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16
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Zhang JK, Del Valle A, Ivankovic S, Patel N, Alexopoulos G, Khan M, Durrani S, Patel M, Tecle NE, Sujijantarat N, Jenson AV, Zammar SG, Huntoon K, Goulart CR, Wilkinson BM, Bhimireddy S, Britz GW, DiLuna M, Prevedello DM, Dinh DH, Mattei TA. Educational impact of early COVID-19 operating room restrictions on neurosurgery resident training in the United States: A multicenter study. NORTH AMERICAN SPINE SOCIETY JOURNAL 2022; 9:100104. [PMID: 35224520 PMCID: PMC8856749 DOI: 10.1016/j.xnsj.2022.100104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/14/2022] [Accepted: 02/14/2022] [Indexed: 12/19/2022]
Abstract
Background The coronavirus (COVID-19) pandemic has caused unprecedented suspensions of neurosurgical elective surgeries, a large proportion of which involve spine procedures. The goal of this study is to report granular data on the impact of early COVID-19 pandemic operating room restrictions upon neurosurgical case volume in academic institutions, with attention to its secondary impact upon neurosurgery resident training. This is the first multicenter quantitative study examining these early effects upon neurosurgery residents caseloads. Methods A retrospective review of neurosurgical caseloads among seven residency programs between March 2019 and April 2020 was conducted. Cases were grouped by ACGME Neurosurgery Case Categories, subspecialty, and urgency (elective vs. emergent). Residents caseloads were stratified into junior (PGY1-3) and senior (PGY4-7) levels. Descriptive statistics are reported for individual programs and pooled across institutions. Results When pooling across programs, the 2019 monthly mean (SD) case volume was 214 (123) cases compared to 217 (129) in January 2020, 210 (115) in February 2020, 157 (81), in March 2020 and 82 (39) cases April 2020. There was a 60% reduction in caseload between April 2019 (207 [101]) and April 2020 (82 [39]). Adult spine cases were impacted the most in the pooled analysis, with a 66% decrease in the mean number of cases between March 2020 and April 2020. Both junior and senior residents experienced a similar steady decrease in caseloads, with the largest decreases occurring between March and April 2020 (48% downtrend). Conclusions Results from our multicenter study reveal considerable decreases in caseloads in the neurosurgical specialty with elective adult spine cases experiencing the most severe decline. Both junior and senior neurosurgical residents experienced dramatic decreases in case volumes during this period. With the steep decline in elective spine cases, it is possible that fellowship directors may see a disproportionate increase in spine fellowships in the coming years. In the face of the emerging Delta and Omicron variants, programs should pay attention toward identifying institution-specific deficiencies and developing plans to mitigate the negative educational effects secondary to such caseloads reduction.
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Affiliation(s)
- Justin K Zhang
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Armando Del Valle
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Sven Ivankovic
- Department of Neurological Surgery, University of Illinois College of Medicine Peoria, Peoria, Illinois, 61605, US
| | - Niel Patel
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Georgios Alexopoulos
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Maheen Khan
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Sulaman Durrani
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Mayur Patel
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | - Najib El Tecle
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
| | | | - Amanda V Jenson
- Department of Neurosurgery, Houston Methodist Neurological Institute, Houston, Texas, 77030, US
| | - Samer G Zammar
- Department of Neurosurgery, Penn State College of Medicine, Hershey, Pennsylvania, 17033, US
| | - Kristin Huntoon
- Department of Neurosurgery, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Carlos R Goulart
- Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, New York, 13210, US
| | - Brandon M Wilkinson
- Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, New York, 13210, US
| | - Sujit Bhimireddy
- Department of Neurological Surgery, University of Illinois College of Medicine Peoria, Peoria, Illinois, 61605, US
| | - Gavin W Britz
- Department of Neurosurgery, Houston Methodist Neurological Institute, Houston, Texas, 77030, US
| | - Michael DiLuna
- Department of Neurosurgery, Yale University, New Haven, Connecticut, 06510, USA
| | - Daniel M Prevedello
- Department of Neurosurgery, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Dzung H Dinh
- Department of Neurological Surgery, University of Illinois College of Medicine Peoria, Peoria, Illinois, 61605, US
| | - Tobias A Mattei
- Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, 63104, US
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17
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Pediatric Training Crisis of Emergency Medicine Residency during the COVID-19 Pandemic. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9010032. [PMID: 35053657 PMCID: PMC8773981 DOI: 10.3390/children9010032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/11/2021] [Accepted: 12/28/2021] [Indexed: 11/17/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is an emerging viral disease that has caused a global pandemic. Among emergency department (ED) patients, pediatric patient volume mostly and continuously decreased during the pandemic period. Decreased pediatric patient volume in a prolonged period could results in inadequate pediatric training of Emergency Medicine (EM) residents. We collected data regarding pediatric patients who were first seen by EM resident physicians between 1 February 2019, and 31 January 2021, which was divided into pre-epidemic and epidemic periods by 1 February 2020. A significant reduction in pediatric patients per hour (PPH) of EM residents was noted in the epidemic period (from 1.55 to 0.81, p < 0.001). The average patient number was reduced significantly in the classification of infection (from 9.50 to 4.00, p < 0.001), respiratory system (from 84.00 to 22.00, p < 0.001), gastrointestinal system (from 52.00 to 34.00, p = 0.007), otolaryngology (from 4.00 to 2.00, p = 0.022). Among the diagnoses of infectious disease, the most obvious drop was noted in the diagnosis of influenza and enterovirus infection. Reduced pediatric patient volume affected clinical exposure to pediatric EM training of EM residency. Changes in the proportion of pediatric diseases presented in the ED may induce inadequate experience with common and specific pediatric diseases.
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18
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Wajekar A, Pargunde S, Thota R. Quantitative analysis of loss of anesthesia management opportunities and procedural skills due to COVID-19 pandemic lockdown: An experience of six months from a tertiary care cancer teaching institute. J Anaesthesiol Clin Pharmacol 2022; 38:S46-S51. [PMID: 36060192 PMCID: PMC9438831 DOI: 10.4103/joacp.joacp_97_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/05/2021] [Accepted: 05/20/2021] [Indexed: 12/03/2022] Open
Abstract
Background and Aims: COVID-19 has necessitated restrictions on elective surgical workload, which could adversely affect the learning of the core clinical competencies of the postgraduate anesthesiology trainees. The aim was to assess and compare the loss of elective cases requiring anesthesia management and associated procedural skills in six months since lockdown compared to the same duration in 2019. Material and Methods: We compared the data, obtained from electronic medical records, of the total number of elective surgeries requiring anesthesia management and the following procedural skills in both adults and pediatric patients in 6 months duration in 2019 and 2020: 1) Laryngoscopy and Intubation 2) Laryngeal mask airway 3) Arterial and central line cannulations and 4) Spinal, Epidural, Other Regional blocks. Results: A total of 8458 and 3561 elective procedures were performed in the six-month period in 2019 and 2020 respectively, reflecting a 57.9% reduction due to lockdown. There was a proportionate reduction in the adult and pediatric procedures, operating room and non-operating room procedures, and surgeries performed under general anesthesia and monitored anesthesia care. There was a significant increase in the number of surgeries performed under regional anesthesia (486%). Epidurals blocks and other regional blocks also showed a proportionate reduction respectively. Although the total number of video-laryngoscopy assisted intubations show an absolute reduction, when compared to the total number of cases performed in the respective years, we found an increase (2.06% in 2019 vs 3.8% in 2020). The arterial cannulations reduced by 43.29% but the central line cannulations reduced by only 12.28%. Conclusion: There was a significant reduction in both the anesthesia management opportunities and in the total number of associated procedural skills due to COVID-19 lockdown which could adversely affect the learning of core clinical competencies of postgraduate trainees.
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19
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Chen SY, Lo HY, Hung SK. What is the impact of the COVID-19 pandemic on residency training: a systematic review and analysis. BMC MEDICAL EDUCATION 2021; 21:618. [PMID: 34911503 PMCID: PMC8671601 DOI: 10.1186/s12909-021-03041-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 11/25/2021] [Indexed: 05/10/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has greatly affected medical education in addition to clinical systems. Residency training has probably been the most affected aspect of medical education during the pandemic, and research on this topic is crucial for educators and clinical teachers. The aim of this study was to understand the effect of the COVID-19 pandemic comprehensively through a systematic review and analysis of related published articles. METHODS A systematic review was conducted based on a predesigned protocol. We searched MEDLINE and EMBASE databases until November 30, 2020, for eligible articles. Two independent reviewers extracted data by using a customized form to record crucial information, and any conflicts between the two reviewers were resolved through discussion with another independent reviewer. The aggregated data were summarized and analyzed. RESULTS In total, 53 original articles that investigated the effect of the COVID-19 pandemic on residency training were included. Studies from various regions were included in the research, with the largest percentage from the United States (n = 25, 47.2%). Most of these original articles were questionnaire-based studies (n = 44, 83%), and the research target groups included residents (79.55%), program directors (13.64%), or both (6.82%). The majority of the articles (n = 37, 84.0%) were published in countries severely affected by the pandemic. Surgery (n = 36, 67.92%) was the most commonly studied field. CONCLUSIONS The COVID-19 pandemic has greatly affected residency training globally, particularly surgical and interventional medical fields. Decreased clinical experience, reduced case volume, and disrupted education activities are major concerns. Further studies should be conducted with a focus on the learning outcomes of residency training during the pandemic and the effectiveness of assisted teaching methods.
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Affiliation(s)
- Shou-Yen Chen
- Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, 333, Taoyuan City, Taiwan
- Graduate Institute of Clinical Medical Sciences; Division of Medical Education, College of Medicine, Chang Gung University, 333, Taoyuan City, Taiwan
| | - Hsiang-Yun Lo
- Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, 333, Taoyuan City, Taiwan
| | - Shang-Kai Hung
- Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, 333, Taoyuan City, Taiwan.
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20
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The impact of the COVID-19 pandemic on global neurosurgical education: a systematic review. Neurosurg Rev 2021; 45:1101-1110. [PMID: 34623526 PMCID: PMC8497188 DOI: 10.1007/s10143-021-01664-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/22/2021] [Accepted: 09/30/2021] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic has disrupted neurosurgical training worldwide, with the shutdown of academic institutions and the reduction of elective surgical procedures. This impact has disproportionately affected LMICs (lower- and/or middle-income countries), already burdened by a lack of neurosurgical resources. Thus, a systematic review was conducted to examine these challenges and innovations developed to adapt effective teaching and learning for medical students and neurosurgical trainees. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) and The Cochrane Handbook of Systematic Reviews of Interventions. MEDLINE, PubMed, Embase and Cochrane databases were accessed, searching and screening literature from December 2019 to 5th December 2020 with set inclusion and exclusion criteria. Screening identified 1254 articles of which 26 were included, providing data from 96 countries. Twenty-three studies reported transition to online learning, with 8 studies also mentioned redeployment into COVID wards with 2 studies mentioning missed surgical exposure as a consequence. Of 7 studies conducted in LMICs, 3 reported residents suffering financial insecurities from reduced surgical caseload and recession. Significant global disruption in neurosurgical teaching and training has arisen from the COVID-19 pandemic. Decreased surgical exposure has negatively impacted educational provision. However, advancements in virtual technology have allowed for more affordable, accessible training especially in LMICs. Using this, initiatives to reduce physical and mental stress experienced by trainees should be paramount.
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21
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Garg K, Mishra S, Raheja A, Verma S, Tandon V, Agrawal S, Suri A, Chandra PS, Prada F, Servadei F, Kale SS, Srivastava P. Hybrid Workshops During the COVID-19 Pandemic-Dawn of a New Era in Neurosurgical Learning Platforms. World Neurosurg 2021; 157:e198-e206. [PMID: 34624519 PMCID: PMC8523585 DOI: 10.1016/j.wneu.2021.09.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 02/02/2023]
Abstract
Background During the COVID-19 pandemic, disruption of surgical hands-on training has hampered the skills acquisition by budding neurosurgeons. Online and virtual classrooms have not been able to substitute the hands-on experience and learning via direct interaction with senior colleagues. To overcome these challenges, we organized a hybrid workshop where simulation-based learning modules, and direct and virtual interaction with surgeons during live surgeries or didactic lectures were utilized to help delegates in understanding the nuances of neurosurgery. Methods A 3-day hybrid workshop was held in March 2021, which was attended by 133 delegates. A structured questionnaire was utilized to record their feedback. Results An overwhelming majority of the respondents (94.1%, n = 64) found hybrid conferences to be better than an online conference. Most of the respondents (88.3%, n = 60) rated the utility of direct face-to-face interaction to be more satisfying as compared with online interaction with faculty during a webinar. Again, many the respondents (86.8%, n = 59) believed that similar hybrid events will be the new normal given the current situation of COVID-19 pandemic. A large majority (88.2%, n = 60) of the respondents reported that they will prefer a hybrid event over an online conference. Conclusions In this era of the COVID-19 pandemic, “hybrid” microneurosurgery workshops offer unique opportunities to enhance surgical skills acquisition by hands-on simulation-based learning and observing live surgical demonstrations, apart from 2-way interactions with experts under one roof. This may be a stepping stone for what lies ahead in the future of neurosurgical training.
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Affiliation(s)
- Kanwaljeet Garg
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Shashwat Mishra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Amol Raheja
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Satish Verma
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Tandon
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
| | - Siddharth Agrawal
- Department of Ophthalmology, King George's Medical University, Lucknow, India
| | - Ashish Suri
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - P S Chandra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Francesco Prada
- Neurosurgery Unit, Department of Neuroscience, Ospedale A. Manzoni, ASST Lecco, Italy; Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA; Acoustic Neuroimaging and Therapy Laboratory, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Focused Ultrasound Foundation, Charlottesville, Virginia, USA
| | - Franco Servadei
- Department of Neurosurgery, Humanitas University and Research Hospital, Milano, Italy
| | - S S Kale
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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22
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Brouwers J, De Leyn P, Depypere LP. Impact of the first COVID-19 wave on surgical training in Flanders: are we losing competence? Acta Chir Belg 2021; 123:221-230. [PMID: 34428131 DOI: 10.1080/00015458.2021.1972588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The COVID-19 pandemic has tremendously impacted the healthcare system and residency programs worldwide. Surgical residents were redeployed to COVID-19 units, whereas education and scientific didactics were reduced. The aim of this study is to identify the impact of COVID-19 on Flemish surgical residents' education, personal life and volume of performed surgeries. METHODS A cross-sectional retrospective survey on educational and personal impact during the first COVID-19 wave was administered anonymously to all surgical residents in Flanders. A quantitative comparison of performed surgeries during this period and the same period a year earlier was conducted. RESULTS A total of 193 surgical residents (46%) completed the survey. 63% of residents were no longer admitted to multidisciplinary oncologic meetings and 107 (55%) residents had no longer any scientific theoretical meetings at all. Almost one in two residents (46%) indicated more than 50% reduction in time in the operating theater and one in three (31%) residents were involved in care for COVID-19 positive surgical patients. Seventy-eight percent of the residents experienced a negative impact on their surgical training and 41% experienced a negative influence on their private situation. Performed surgical cases during the COVID-19 period were on average 40% less for second, third- and fourth-year residents. CONCLUSION Surgical residents perceived a high negative impact on personal and professional lives during the start of the COVID-19 pandemic in Flanders. Education and training programs were cancelled and volume of performed surgeries decreased tremendously. Policymakers and surgical program coordinators should ensure surgical education during further evolution of this and future pandemics.
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Affiliation(s)
- Jonas Brouwers
- Department of Orthopedic Surgery, University Hospitals Leuven, Leuven, Belgium
- Leuven Institute for Health Care Policy, KU Leuven, Leuven, Belgium
| | - Paul De Leyn
- Center for surgical competence, University Hospitals Leuven, Leuven, Belgium
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Lieven P. Depypere
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
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Ataullah AHM, Rahman S, Rahman MM, Agrawal A, Moscote-Salazar LR. Neurosurgical challenges in the second wave of COVID-19; a global pandemic. INTERNATIONAL JOURNAL OF SURGERY OPEN 2021; 33:100356. [PMID: 34568621 PMCID: PMC8158347 DOI: 10.1016/j.ijso.2021.100356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 05/16/2021] [Indexed: 10/27/2022]
Affiliation(s)
- A H M Ataullah
- Sher-E-Bangla Medical College Hospital, Barishal, Bangladesh
| | - Sabrina Rahman
- Department of Public Health, Independent University- Bangladesh, Dhaka, Bangladesh
| | - Md Moshiur Rahman
- Neurosurgery Department, Holy Family Red Crescent Medical College, Dhaka, Bangladesh
| | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, India
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24
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Azab MA, Azzam AY. Impact of COVID-19 pandemic on the management of glioma patients around the world. An evidence-based review. BRAIN DISORDERS 2021; 2:100012. [PMID: 33997826 PMCID: PMC8106822 DOI: 10.1016/j.dscb.2021.100012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/08/2021] [Indexed: 02/06/2023] Open
Abstract
Background The coronavirus pandemic has affected many health care services worldwide since the emergence of the first case in Wuhan. Surgical neuro-oncology care is a fundamental part of hospital services, making it susceptible to strategic changes amid the COVID-19 pandemic. Methods An electronic search on several databases (PubMed/Medline, Scopus, and Google Scholar) from the beginning of the pandemic to the end of 2020, each paper was reviewed independently. The publication inclusion and exclusion criteria were done using Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Results Eight studies were found to be eligible for our meta-analysis. Most of the studies were on a retrospective basis, except one which was retrospective and prospective. An overall of 951 glioma patients’ were included for surgical admission from the beginning of the pandemic until 2020. Seventy-four patients' had mortality outcomes, and 250 patients had complications for both surgical admitted and non-surgical admitted purposes. Conclusions To our knowledge, we made the first systematic review and meta-analysis regarding the management of glioma patients’ during the pandemic of COVID-19. Our main findings are that the number of surgical admissions for glioma patients’ did not significantly differ between COVID-19 negative and COVD-19 positive cases; however, surprisingly, we found that both overall complications and mortality outcomes were more significant COVID-19 negative patients’ from the reported studies.
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Affiliation(s)
- Mohammed A Azab
- Department of Neurosurgery, Cairo University Faculty of Medicine, Cairo, Egypt
| | - Ahmed Y Azzam
- October 6 University Faculty of Medicine, Giza, Egypt
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25
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Kilgore MD, Scullen T, Mathkour M, Dindial R, Carr C, Zeoli T, Werner C, Kahn L, Bui CJ, Keen JR, Maulucci CM, Dumont AS. Effects of the COVID-19 Pandemic on Operative Volume and Residency Training at Two Academic Neurosurgery Centers in New Orleans. World Neurosurg 2021; 151:e68-e77. [PMID: 33812067 DOI: 10.1016/j.wneu.2021.03.122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Medical subspecialties including neurosurgery have seen a dramatic shift in operative volume in the wake of the coronavirus disease 2019 (COVID-19) pandemic. The goal of this study was to quantify the effects of the COVID-19 pandemic on operative volume at 2 academic neurosurgery centers in New Orleans, Louisiana, USA from equivalent periods before and during the COVID-19 pandemic. METHODS A retrospective review was conducted analyzing neurosurgical case records for 2 tertiary academic centers from March to June 2020 and March to June 2019. The records were reviewed for variables including institution and physician coverage, operative volume by month and year, cases per subspecialty, patient demographics, mortality, and morbidity. RESULTS Comparison of groups showed a 34% reduction in monthly neurosurgical volume per institution during the pandemic compared with earlier time points, including a 77% decrease during April 2020. There was no change in mortality and morbidity across institutions during the pandemic. CONCLUSIONS The COVID-19 pandemic has had a significant impact on neurosurgical practice and will likely continue to have long-term effects on patients at a time when global gross domestic products decrease and relative health expenditures increase. Clinicians must anticipate and actively prepare for these impacts in the future.
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Affiliation(s)
- Mitchell D Kilgore
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Tyler Scullen
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Mansour Mathkour
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA; Neurosurgery Division, Department of Surgery, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Rishawn Dindial
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Christopher Carr
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Tyler Zeoli
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Cassidy Werner
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA
| | - Lora Kahn
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Cuong J Bui
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Joseph R Keen
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Christopher M Maulucci
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
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26
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Letter to the Editor Regarding "Early Effects of COVID-19 Pandemic on Neurosurgical Training in the United States: A Case Volume Analysis of 8 Programs". World Neurosurg 2021; 146:411-413. [PMID: 33607741 DOI: 10.1016/j.wneu.2020.10.162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 12/23/2022]
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27
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Aljuboori Z. In Reply to the Letter to the Editor Regarding "Early Effects of COVID-19 Pandemic on Neurosurgical Training in the United States: A Case Volume Analysis of Eight Programs". World Neurosurg 2021; 146:414. [PMID: 33607742 PMCID: PMC7884221 DOI: 10.1016/j.wneu.2020.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 11/02/2020] [Indexed: 11/23/2022]
Affiliation(s)
- Zaid Aljuboori
- Department of Neurosurgery, University of Louisville, Louisville, Kentucky, USA.
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