Patients awaiting surgery for neurosurgical diseases during the first wave of the COVID-19 pandemic in Spain: a multicentre cohort study.
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Castaño-Leon Ana M, Paredes Igor, Lagares Alfonso, Gomez Pedro A, González-Leon Pedro, Perez-Nuñez Angel, Jiménez-Roldán Luis, Delgado-Fernández Juan, Eiriz Fernández Carla, García-Pérez Daniel, Moreno-Gómez Luis M, Esteban-Sinovas Olga, Delgado-López Pedro D, Martín-Alonso Javier, Kaen Ariel, Tirado-Caballero Jorge, Ordóñez-Carmona Marta, Arteaga-Romero Francisco, González-Pombo Marta, F Alén José, Gil-Simoes Ricardo, Torres Cristina V, Navas-García Marta, Blasco García de Andoain Guillermo, Frade-Porto Natalia, González-Tarno Patricia, Martin Segura Adrian, Gelabert-González Miguel, Menéndez-Cortezón Beatriz, Rodríguez-Botana Brais, Pérez-Alfayate Rebeca, Fernández-García Carla, Ferrández-Pujante Borja, Vargas-Jiménez Andres C, Cotúa Carlos, de la Lama Adolfo, Calero Félix Lourdes, Ruiz-Juretschke Fernando, García-Leal Roberto, Valera-Melé Marc, Casitas Hernando Vicente, Rivero Belén, Orduna-Martínez Javier, Casado Pellejero Juan, Fustero De Miguel David, Díaz Molina Jorge, Moles Herbera Jesús, Castelló-Ruiz Maria J, Gomar-Alba Mario, García-Pérez Fernando, Hernández-García Borja J, Villaseñor-Ledezma Jorge J, Otero-Rodríguez Álvaro, Ailagas de Las Heras Juan J, Gonçalves-Estella Jesus, Sousa-Casasnovas Pablo, Pascual-Argente Daniel, Ruiz Martín Laura, Roa Montes de Oca Juan C, Arandia Guzmán Daniel, García Martín Andoni, Torres Carretero Luis, Garrido Ruiz Alejandra, Calvo Marta, Miranda-Lloret Pablo, Rodríguez-Cadarso Miguel, Antón Joan, Roca Barber Amparo, Quiroz-Tejada Arnold, Carbayo-Lozano Guillermo, Bermúdez Garazi, Paternain Martin Clara, De la Fuente Villa Pablo, Fidalgo De la Rosa Marina, Sistiaga-Gracia Íñigo L, Zabalo Gorka
Аннотация
DESIGN: This was an observational retrospective study.
SETTINGS: A tertiary-level multicentre study of neurosurgery activity between 1 March and 30 June 2020.
PARTICIPANTS: A total of 680 patients awaiting any scheduled neurosurgical procedure were enrolled. 470 patients (69.1%) were awaiting surgery because of spine degenerative disease, 86 patients (12.6%) due to functional disorders, 58 patients (8.5%) due to brain or spine tumours, 25 patients (3.7%) due to cerebrospinal fluid (CSF) disorders and 17 patients (2.5%) due to cerebrovascular disease.
PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was mortality due to any reason and any deterioration of the specific neurosurgical condition. Second, we analysed the rate of confirmed SARS-CoV-2 infection.
RESULTS: More than one-quarter of patients experienced clinical or radiological deterioration. The rate of worsening was higher among patients with functional (39.5%) or CSF disorders (40%). Two patients died (0.4%) during the waiting period, both because of a concurrent disease. We performed a multivariate logistic regression analysis to determine independent covariates associated with maintaining the surgical indication. We found that community SARS-CoV-2 incidence (OR=1.011, p<0.001), degenerative spine (OR=0.296, p=0.027) and expedited indications (OR=6.095, p<0.001) were independent factors for being operated on during the pandemic.
CONCLUSIONS: Patients awaiting neurosurgery experienced significant collateral damage even when they were considered for scheduled procedures.