Journal of Neurosurgical Sciences 2020 Jun 11

DOI: 10.23736/S0390-5616.20.05018-3

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Remodulation of neurosurgical activities in an Italian region (Emilia-Romagna) under COVID- 19 emergency: maintaining the standard of care during the crisis

Diego MAZZATENTA ^{1, 2}, Matteo ZOLI ^{1, 2} ✉, Michele A. CAVALLO ³, Salvatore FERRO ⁴, Ermanno GIOMBELLI ⁵, Giacomo PAVESI ⁶, Carmelo STURIALE ⁷, Luigino TOSATTO ⁸, Mino ZUCCHELLI ⁹

¹ Center for the Diagnosis and Treatment of Hypothalamic-Pituitary Diseases, Pituitary Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; ² Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy; ³ Neurosurgery Division, Department of Morphology, Surgery, and Experimental Medicine, Hospital S. Anna, Ferrara University, Ferrara, Italy; ⁴ Department of Hospital Services, Emilia-Romagna Regional Health Authority, Bologna, Italy; ⁵ Department of Neurosurgery, Azienda Ospedaliero-Universitaria, Parma, Italy; ⁶ Unit of Neurosurgery, Department of Neurosciences, NOCSAE Modena Hospital, Modena, Italy; ⁷ Department of Neurosurgery, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; ⁸ Neurosurgery Department, “Maurizio Bufalini” Hospital, Cesena, Italy; ⁹ Center of Pediatric Neurosurgery, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy

BACKGROUND: The impact of COVID-19 outbreak in the neurosurgical practice has been dramatic, imposing several limitations. The aim of this study is to present how the neurosurgical departments of Emilia-Romagna, a northern Italian region, have re-set their organization to maintain the higher standard of care as possible.
METHODS: All OR and out-patients activities performed during the COVID-19 emergency in the neurosurgical department of Emilia-Romagna have been collected and compared to the means of the same timeframe in 2018 and 2019.
RESULTS: In 2020, 205 surgical procedures and 466 out-patients consultations have been performed, representing respectively 28.8% and 26.4% of the previous biennium. The most of OR procedures had been emergencies/urgencies and oncological patients (respectively 113 and 66 vs 164.5 and 84.5 of the previous biennium), while elective surgeries decrease up to -97.1%, as for spinal nerves and endoscopic skull base procedures. The patients phone contacts and telemedicine evaluations of their examinations have permitted to reduce the hospital access for outpatients of 75.6%, but these modalities have, also, permitted to follow-up a large number of cases.
CONCLUSIONS: The outbreak of COVID-19 has imposed several limits to our current practice, however this should not represent an excuse to reduce the standard of care. In our experience, the net integration of different local centers has permitted for each of them to effectively cope the crisis, managing the local cases requiring a prompt surgery and keeping the care continuity with already discharged patients.

KEY WORDS: Neurosurgery; COVID-19; Sars-CV2; Emergency; Standard of care; Out-patient; Surgery