Next Article in Journal / Special Issue
Professional Quality of Life and Perceived Stress in Health Professionals before COVID-19 in Spain: Primary and Hospital Care
Previous Article in Journal
Impact of Internet Use on Elderly Health: Empirical Study Based on Chinese General Social Survey (CGSS) Data
Previous Article in Special Issue
A Drive-through Simulation Tool for Mass Vaccination during COVID-19 Pandemic
Article

The Demand for Elective Neurosurgery at a German University Hospital during the First Wave of COVID-19

Department of Neurosurgery, University Marburg, Baldingerstr, 35033 Marburg, Germany
*
Author to whom correspondence should be addressed.
Healthcare 2020, 8(4), 483; https://doi.org/10.3390/healthcare8040483
Received: 22 October 2020 / Revised: 6 November 2020 / Accepted: 9 November 2020 / Published: 13 November 2020
(This article belongs to the Special Issue COVID-19 Pandemic: Challenges Facing the Health System)
Background: Patients’ fear of the coronavirus disease 2019 (COVID-19) may delay inevitable treatment, putting potential benefits at risk. This single-center retrospective study aims to analyze temporal relationships of the first wave of the COVID-19 pandemic in Germany with the number of patients who sought and received elective neurosurgical treatment at a German university hospital. Methods: Daily outpatient numbers (ON) and elective procedures (EP) were recorded at our department between 1 January 2020 and 30 June 2020 (baseline: between 1 January 2019 and 30 June 2019). In patients who received EP, we recorded indication, outcome, and length of stay (LOS). Moving averages of ON (MAON) and of EP were calculated. Data on governmental action taken in response to the pandemic and on coronavirus-positive cases in Germany (CPCG) were superimposed. Exponential and arc tangent curves (ATC) were fitted to the absolute numbers of CPCG. Phase shifts were estimated, and Spearman’s rank correlation coefficient, rho, was calculated between the 2020 MAON and the derivative function of the fitted ATC (DFATC). Wilcoxon rank sum served as statistical test. Significance was assumed with p values of less than 0.05. Results: ON were significantly decreased in April 2020 as compared to April 2019 (p = 0.010). A phase shift between the German lockdown, the DFATC, and the decrease in MAON was not detected, while a phase shift of 10 days between the DFATC and the subsequent increase in MAON was detected. The DFATC was significantly negatively correlated (rho = −0.92, p < 0.0001) to the MAON until 31 March 2020, and, when shifted by 10 days, the DFATC was significantly negatively correlated (rho = −0.87, p < 0.0001) to the MAON from 01 April 2020. EP (p = 0.023), including the subset of non-oncological EP (p = 0.032), were significantly less performed in the first half of 2020 as compared to the first half of 2019. In March and April 2020, we conducted significantly more EP due to motor deficits (p = 0.0267, and less), visual disturbances (p = 0.0488), and spinal instability (p = 0.0012), and significantly less EP due to radicular pain (p = 0.0489), as compared to March and April 2019. LOS ranked significantly higher in patients who received cranial or spinal EP in March and April 2020 as compared to March and April 2019 (p = 0.0497). Significant differences in outcome were not observed. Conclusion: The beginning of the COVID-19 pandemic was correlated to an immediate and significant decrease in ON, and to a significant decrease in the number of EP performed. The subsequent increase in ON was delayed. Adequate measures to promote timely discharge of patients may become increasingly relevant as the pandemic proceeds. Although we observed a shift in the range of indications towards significantly more EP in patients with neurological deficiencies, care should be taken to avoid potentially deleterious delays of necessary elective treatment in future pandemic situations. View Full-Text
Keywords: neurosurgery; COVID-19; public education; healthcare neurosurgery; COVID-19; public education; healthcare
Show Figures

Figure 1

MDPI and ACS Style

Rupa, R.; Sass, B.; Morales Lema, M.A.; Nimsky, C.; Voellger, B. The Demand for Elective Neurosurgery at a German University Hospital during the First Wave of COVID-19. Healthcare 2020, 8, 483. https://doi.org/10.3390/healthcare8040483

AMA Style

Rupa R, Sass B, Morales Lema MA, Nimsky C, Voellger B. The Demand for Elective Neurosurgery at a German University Hospital during the First Wave of COVID-19. Healthcare. 2020; 8(4):483. https://doi.org/10.3390/healthcare8040483

Chicago/Turabian Style

Rupa, Rosita, Benjamin Sass, Maria A. Morales Lema, Christopher Nimsky, and Benjamin Voellger. 2020. "The Demand for Elective Neurosurgery at a German University Hospital during the First Wave of COVID-19" Healthcare 8, no. 4: 483. https://doi.org/10.3390/healthcare8040483

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop