Tracking the Volume of Neurosurgical Care during the COVID-19 Pandemic

OBJECTIVE: This study quantifies the impact of COVID-19 on the volume of adult and pediatric neurosurgical procedures, inpatient consults, and clinic visits at an academic medical center METHODS: Neurosurgical procedures, inpatient consults, and outpatient appointments at Vanderbilt University Medical Center were identified in the time periods of March 23, 2020 through May 8, 2020 ("During COVID-19") and March 25, 2019 through May 10, 2019 ("Before COVID-19") Neurosurgical volume was compared between these periods RESULTS: A 40% reduction in weekly procedural volume was demonstrated during COVID-19 (median 75 [IQR 72-80] to 45 [43-47], p0 001) There was a 42% reduction for weekly adult procedures (62 [54-70] to 36 [34-39], p0 001), and 31% reduction for weekly pediatric procedures (13 [12-14] to 9 [8-10], p=0 004) Among adult procedures, the most significant decreases were seen for spine (p0 001), endovascular (p0 001), and cranioplasty (p0 001) There was not a significant change for adult open vascular (p=0 291), functional (p=0 263), cranial tumor (p=0 143), or hydrocephalus (p=0 173) procedural volume Weekly inpatient consults to neurosurgery decreased by 24% (99 [94-114] to 75 [68-84], p=0 008) for adults Weekly in-person adult and pediatric outpatient clinic visits witnessed a 91% decrease (329 [326-374] to 29 [26-39], p0 001) Weekly telehealth encounters increased from 0 [0-0] to 151 [126-156] (p0 001) CONCLUSION: There were significant reductions in neurosurgical operations, clinic visits, and inpatient consults during COVID-19 Telehealth was increasingly used for assessment The long-term impacts of reduced neurosurgical volume and increased telehealth utilization on patient outcomes should be explored