Neuro-oncology practice guidelines from a high-volume surgeon at the COVID-19 epicenter.
Neuro-oncology practice guidelines from a high-volume surgeon at the COVID-19 epicenter.
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DOI：
10.1016/j.jocn.2020.12.012
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Komotar R
中科院分区：
文献类型：
--
作者：
Luther E;Burks J;Eichberg DG;Basil G;Berry K;Lu V;Shah A;Kaur G;Ivan M;Komotar R
在新型冠状病毒19（COVID-19）大流行期间，医生已开始调整其日常做法以防止传播。在这项研究中，我们的目标是在COVID-19大流行期间为外科神经肿瘤学家提供实践指南，该指南基于当前COVID-19震中的高容量脑肿瘤外科医生的客观数据。在最初的隔离期（20年3月23日至20年5月4日）、隔离后的平稳期（20年5月5日至20年6月27日）和第二个高峰期（20年6月28日至20年7月20日）之间，对资深作者在COVID-19大流行期间进行的所有门诊和手术进行了比较。对面对面和远程医疗访问进行了交叉评价。根据病变类型对surgery进行细分，并在同一时间段内进行评价。从2020年3月23日至2020年7月20日，确定了469次门诊访视和196次手术。隔离解除后，面对面访问增加（P < 0.01），但远程保健访问没有发生变化。在327次远程医疗访问中，只有5.8%在4个月期间转换为面对面，最常见的原因是患者偏好（68.4%）。在大流行期间进行的196例手术中，29.1%发生在隔离期间，49.0%发生在平台期，21.9%发生在第二个高峰期。随访时，无COVID阴性患者出现症状。恶性肿瘤占55.6%，良性肿瘤占31.6%，在整个大流行期间病例量没有差异。尽管面临特殊挑战，我们仍在COVID-19疫情中心维持高产量的神经肿瘤外科业务。我们提供在我们机构实施的方案，以最大限度地提高神经肿瘤护理，同时降低患者和提供者接触COVID-19的风险。
During the coronavirus 19 (COVID-19) pandemic, physicians have begun adapting their daily practices to prevent transmissions. In this study we aimed to provide surgical neuro-oncologists with practice guidelines during the COVID-19 pandemic based on objective data from a high-volume brain tumor surgeon at the current COVID-19 epicenter. All outpatient visits and surgeries performed by the senior author during the COVID-19 pandemic were compared between the initial quarantine (3/23/20–5/4/20), the plateau period following quarantine (5/5/20–6/27/20), and the second peak (6/28/20–7/20/20). In-person and telemedicine visits were evaluated for crossovers. Surgeries were subdivided based on lesion type and evaluated across the same time period. From 3/23/20–7/20/20, 469 clinic visits and 196 surgeries were identified. After quarantine was lifted, face-to-face visits increased (P < 0.01) yet no change in telehealth visits occurred. Of 327 telehealth visits, only 5.8% converted to in-person during the 4-month period with the most cited reason being patient preference (68.4%). Of the 196 surgeries performed during the pandemic, 29.1% occurred during quarantine, 49.0% during the plateau, and 21.9% occurred in the second peak. No COVID negative patients developed symptoms at follow-up. 55.6% were performed on malignant tumors and 31.6% were benign with no difference in case volumes throughout the pandemic. Despite exceptional challenges, we have maintained a high-volume surgical neuro-oncology practice at the epicenter of the COVID-19 pandemic. We provide the protocols implemented at our institution in order to maximize neuro-oncology care while mitigating risk of COVID-19 exposure to both patients and providers.
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DOI：
10.1007/s00464-020-07565-w
发表时间：
2020-04-22
影响因子：
3.1
作者：
Francis, Nader;Dort, Jonathan;Pryor, Aurora
通讯作者：
Pryor, Aurora
影响因子：
2
作者：
Richardson, Angela M.;McCarthy, David J.;Ivan, Michael
通讯作者：
Ivan, Michael
影响因子：
2.4
作者：
Luther, Evan;Berry, Katherine;Ivan, Michael
通讯作者：
Ivan, Michael
影响因子：
2.7
作者：
Gupta, Tejpal;Singh, Varindera P.;Jalali, Rakesh
通讯作者：
Jalali, Rakesh
影响因子：
2
作者：
Eichberg, Daniel G.;Di, Long;Komotar, Ricardo J.
通讯作者：
Komotar, Ricardo J.