ORIGINAL
Introdução: a pandemia do SARS-COV-2 sobrecarregou diversos sistemas de saúde pelo mundo, sendo necessário reduzir algumas atividades médicas para suprir a demanda de hospitalizações por COVID-19 e evitar o colapso de assistência. A suspensão de cirurgias foi uma das medidas adotadas em boa parte do mundo, sobretudo de caráter eletivo. Impactos na Neurocirurgia foram reportados em outros países, mas no Brasil ainda não foram explorados. Objetivo: caracterizar o impacto da COVID-19 nos procedimentos neurocirúrgicos eletivos e de urgência em regiões do Brasil durante as duas primeiras ondas. Métodos: trata-se de um estudo descritivo, observacional, baseado em dados fixos e agregados sobre procedimentos neurocirúrgicos realizados entre janeiro de 2017 e setembro de 2021, coletados retrospectivamente pelo banco de dados do Sistema Único de Saúde – Datasus. Os dados foram analisados de acordo com o tipo de procedimento, subespecialidade, caráter de atendimento (urgência/eletivo), comparando a média dos procedimentos entre o período pré-pandemia e de pandemia. Resultados: a média de procedimentos neurocirúrgicos no Sistema Público de Saúde Brasileiro foi de 8.787,4 por mês antes da Covid-19 emergir, sendo 41,8% eletivas e 58,2% de urgência. A média mensal de neurocirurgias diminuiu 22,2% no período pandêmico. Tal queda foi vista especialmente nas cirurgias eletivas, -42,82%*. Uma diminuição significativa dos procedimentos de urgência foi vista na região Norte (-15,34%*) e no Sul (-22,53%*) *p<0,001. Conclusão: a Covid-19 sobrecarregou o departamento de Neurocirurgia, especialmente em procedimentos eletivos. Baseado nos nossos achados, supomos que muitos pacientes perderam a janela de tratamento para operar, enfrentando piores desfechos como uma consequência lamentável.
Introduction: SARS-COV-2 pandemic has overwhelmed several health systems around the world, obliging to reduce some medical activities to meet the demand for hospitalizations by COVID-19 and avoid the collapse of care. Suspension of surgeries was one of the measures adopted in many places of the world, especially those of elective nature. Impacts on Neurosurgery have been reported in other countries, but impacts in Brazil have not yet been explored. Objective: to characterize the impact of COVID-19 on elective and urgent neurosurgical procedures in regions of Brazil during the first two waves of cases. Methods: this is a descriptive and observational study, based on aggregated and fixed data on neurosurgical procedures performed from January 2017 to September 2021, retrospectively collected from the Unified Health System Database – Datasus. Data were analyzed according to the type of procedure, subspecialty, character of care (urgency/elective), comparing the average of the procedures between the pre-pandemic and pandemic period. Results: the average number of Neurosurgical procedures in the Brazilian Public Health System was 8,787.4 per month before Covid-19 had emerged, being 41.8% electives and 58.2% urgent procedures. The mean monthly number of neurosurgeries decreased 22.2% in the Pandemic period. This dropdown is specially seen with electives surgeries, -42,82%*. Significant decrease of urgent procedures was seen in North (-15.34%*) and South (-22.53%*) regions *p<0.001. Conclusion: COVID-19 overwhelmed Neurosurgical department, especially regarding elective procedures. Based on our findings, we suppose that many patients had lost the optimal timing to be operated on, facing worsing outcomes as an unfortunate consequence.
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1 Medical Student, Bahiana School of Medicine and Public Health – EBMSP, Salvador, BA, Brazil.
2 MD, PhD, Neurosurgeon, Neurosurgery Department, Atenas University, Passos, MG, Brazil.
Received Jan 19, 2023
Accepted Feb 20, 2023
