Abstract

ObjectiveDuring the COVID-19 pandemic, certain precautionary measures were implemented to limit its effect, including the cancellation of clinics and elective surgical lists. To determine the impact, if any, of the pandemic on the running of a neurosurgical service, an audit was performed on the volume of referrals, admissions and type of surgeries performed at a tertiary institute in a low-resource setting.MethodsAn audit of the neurosurgical department’s database was performed on the number of referrals, admissions, surgical procedures, and types of procedures done at the San Fernando General Hospital. This was divided into two 15-month periods, pre-pandemic (January 1, 2019 to March 31, 2020) and intra-pandemic (April 1, 2020 - June 30, 2021).ResultsDuring the pre-pandemic period (January 1, 2019 - March 31, 2020), 2,597 patients were referred to the service and 309 major procedures were performed. Two thousand and forty-two patients were referred during the intra-pandemic (April 4, 2020 - June 30, 2021) period, with 354 surgeries performed.More external ventricular drains (29 vs 50), craniotomies for trauma (73 vs 98), anterior cervical fusion (42 vs 47), lumbar fusions (9 vs 12), ventriculo-peritoneal shunts (16 vs 19) and aneurysm clipping (10 vs 13) were done during the intra-pandemic period.ConclusionAlthough elective surgical procedures and clinics were reduced, the number of patients seen and total procedures performed did not vary significantly. The neurosurgical pathology encountered remained constant during the pandemic. This shows the importance of maintaining a fully functional neurosurgical service, as we continue to adapt to the COVID-19 pandemic.

Highlights

  • The COVID-19 pandemic in Trinidad and Tobago created certain challenges in managing the on-call referrals and admissions, surgical procedures and clinics for the neurosurgical department of San FernandoGeneral Hospital (SFGH)

  • An audit of the neurosurgical department’s database was performed on the number of referrals, admissions, surgical procedures, and types of procedures done at the San Fernando General Hospital

  • The COVID-19 pandemic has affected the running of neurosurgical services worldwide, with varying effects seen

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Summary

Introduction

The COVID-19 pandemic in Trinidad and Tobago created certain challenges in managing the on-call referrals and admissions, surgical procedures and clinics for the neurosurgical department of San Fernando. While there were periodical shutdowns of the clinics and elective surgeries due to surges in COVID-19 positive patients, the number of neurosurgical referrals and procedures are done appeared unchanged. Our aim was to audit and analyse the numbers pre-pandemic and intra-pandemic, to ascertain if there was any impact on the care and service provided. If there was a change in the operative volume and type of procedure performed, this would allow for better resource allocation and equipment ordering during this pandemic

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