■在过去的十年中,神经外科干预经历了手术频率和术后住院时间(LOS)的变化,最近的COVID-19大流行对这些指标产生了重大影响。在三级国家卫生服务中心评估这些趋势可以洞悉手术实践和卫生政策对LOS的影响,对于优化医疗管理决策至关重要。
■这是2012年至2022年神经外科手术的单三级中心回顾性病例系列分析。因素包括程序类型、录取紧迫性,和LOS从前瞻性维护的数据库中提取。分析了六个亚专业:脊柱,神经肿瘤学,骷髅基地(SB),Functional,脑脊液(CSF),和周围神经(PN)。进行Mann-Kendall时间趋势检验和探索性数据分析。
■分析了19,237个选修和日间病例操作。在6个子专业中,脊柱,神经肿瘤学,SB,和CSF程序均显示出频率降低的显着趋势。很明显,在选修程序上转向了日常案例,尤其是脊柱(P<0.001),SB(tau=0.733,P=0.0042),功能(tau=0.156,P=0.0016),和PN手术(P<0.005)。在过去的十年里,观察到神经肿瘤学的LOS降低(tau=-0.648,P=0.0077),SB(tau=-0.382,P=0.012),和功能操作,在COVID-19大流行期间,这一趋势保持一致(P=0.01)。脊柱在过去十年中保持不变,而PN表现出LOS增加的趋势。
■大多数子专业显示LOS下降,同时转向日常案例程序,可能归因于手术技术的改进,侵入性较小的方法,增加了床上的压力。设立额外的专用日间案件剧院可以帮助处理积压的程序,特别是关于COVID-19的影响。
UNASSIGNED: Over the past decade, neurosurgical interventions have experienced changes in operative frequency and postoperative length of stay (LOS), with the recent COVID-19 pandemic significantly impacting these metrics. Evaluating these trends in a tertiary National Health Service center provides insights into the impact of surgical practices and health policy on LOS and is essential for optimizing healthcare management decisions.
UNASSIGNED: This was a single tertiary center retrospective case series analysis of neurosurgical procedures from 2012 to 2022. Factors including procedure type, admission urgency, and LOS were extracted from a prospectively maintained database. Six subspecialties were analyzed: Spine, Neuro-oncology, Skull base (SB), Functional, Cerebrospinal fluid (CSF), and Peripheral nerve (PN). Mann-Kendall temporal trend test and exploratory data analysis were performed.
UNASSIGNED: 19,237 elective and day case operations were analyzed. Of the 6 sub-specialties, spine, neuro-oncology, SB, and CSF procedures all showed a significant trend toward decreasing frequency. A shift toward day case over elective procedures was evident, especially in spine (P < 0.001), SB (tau = 0.733, P = 0.0042), functional (tau = 0.156, P = 0.0016), and PN surgeries (P < 0.005). Over the last decade, decreasing LOS was observed for neuro-oncology (tau = -0.648, P = 0.0077), SB (tau = -0.382, P = 0.012), and functional operations, a trend which remained consistent during the COVID-19 pandemic (P = 0.01). Spine remained constant across the decade while PN demonstrated a trend toward increasing LOS.
UNASSIGNED: Most subspecialties demonstrate a decreasing LOS coupled with a shift toward day case procedures, potentially attributable to improvements in surgical techniques, less invasive approaches, and increased pressure on beds. Setting up extra dedicated day case theaters could help deal with the backlog of procedures, particularly with regard to the impact of COVID-19.