A risk assessment strategy to re-introduce elective neurosurgery patients during COVID-19.

Abstract

OBJECTIVES\nTo demonstrate the utilisation of a risk assessment protocol designed to prioritise elective neurosurgical patients against the risks of COVID-19. This tool can be applied to all other surgical specialties.\n\n\nDESIGN\nProspective case series of 166 patients.\n\n\nSETTING\nSingle-centre tertiary neurosurgical department.\n\n\nPARTICIPANTS\nAll patients awaiting an elective neurosurgical procedure were included in this study. All emergency or life-threatening neurosurgical pathologies affecting patients were excluded.\n\n\nMAIN OUTCOME MEASURES\nThe risk assessment tool identified patients with progressive neurology and stratified need for surgery against risk of harm during the COVID-19 pandemic.\n\n\nRESULTS\nUsing our risk stratification tool, 6.6% patients required expedited surgery and a further 11.4% patients were removed completely from the waiting list. The majority of patients 47%, required surgery within 3\xa0months.\n\n\nCONCLUSIONS\nThis simple tool encourages surgical departments to establish contact with patients during COVID-19. The clinician acquires up-to-date information regarding patient symptomatology and subsequently determines surgical priority, a timescale required for surgery and overall uses of NHS resources efficiently. We recommend the use of this tool for all neurosurgical departments, with a wider application to other surgical specialties during the ongoing pressures of elective backlogs secondary to the persistent COVID-19 pandemic.