Perceptions Regarding the SARS-CoV-2 Pandemic's Impact on Neurocritical Care Delivery: Results From a Global Survey

Authors

Abhijit V. Lele, Departments of Anesthesiology and Pain Medicine, and Neurological Surgery.
Sarah Wahlster, Neurology, Anesthesiology and Pain Medicine, and Neurological Surgery, Harborview Medical Center, University of Washington, Seattle, WA.
Bhunyawee Alunpipachathai, Faculty of Medicine, Bhumibol Adulyadej Hospital, Chulalongkorn University, Bangkok, Thailand.
Meron Awraris Gebrewold, Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Sherry H-Y Chou, Departments of Critical Care Medicine, Neurology, and Neurosurgery, University of Pittsburgh, Pittsburgh, PA.
Gretchen Crabtree, Neurocritical Care, OhioHealth Riverside Methodist Hospital, Columbus, OH.
Shane English, Department of Medicine (Critical Care), University of Ottawa, Ottawa, ON, Canada.
Caroline Der-Nigoghossian, Department of Pharmacy, Neurosciences Intensive Care Unit, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York City, NY.

Document Type

Article

Publication Date

4-1-2022

Journal Title

Journal of neurosurgical anesthesiology

MeSH Headings

COVID-19; Critical Care; Delivery of Health Care; Humans; Intensive Care Units; Pandemics; SARS-CoV-2; Surveys and Questionnaires

Abstract

BACKGROUND: The SARS-CoV-2 (COVID-19) pandemic has impacted many facets of critical care delivery. METHODS: An electronic survey was distributed to explore the pandemic's perceived impact on neurocritical care delivery between June 2020 and March 2021. Variables were stratified by World Bank country income level, presence of a dedicated neurocritical care unit (NCCU) and experiencing a COVID-19 patient surge. RESULTS: Respondents from 253 hospitals (78.3% response rate) from 47 countries (45.5% low/middle income countries; 54.5% with a dedicated NCCU; 78.6% experienced a first surge) participated in the study. Independent of country income level, NCCU and surge status, participants reported reductions in NCCU admissions (67%), critical care drug shortages (69%), reduction in ancillary services (43%) and routine diagnostic testing (61%), and temporary cancellation of didactic teaching (44%) and clinical/basic science research (70%). Respondents from low/middle income countries were more likely to report lack of surge preparedness (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.8-5.8) and struggling to return to prepandemic standards of care (OR, 12.2; 95% CI, 4.4-34) compared with respondents from high-income countries. Respondents experiencing a surge were more likely to report conversion of NCCUs and general-mixed intensive care units (ICUs) to a COVID-ICU (OR 3.7; 95% CI, 1.9-7.3), conversion of non-ICU beds to ICU beds (OR, 3.4; 95% CI, 1.8-6.5), and deviations in critical care and pharmaceutical practices (OR, 4.2; 95% CI 2.1-8.2). Respondents from hospitals with a dedicated NCCU were less likely to report conversion to a COVID-ICU (OR, 0.5; 95% CI, 0.3-0.9) or conversion of non-ICU to ICU beds (OR, 0.5; 95% CI, 0.3-0.9). CONCLUSION: This study reports the perceived impact of the COVID-19 pandemic on global neurocritical care delivery, and highlights shortcomings of health care infrastructures and the importance of pandemic preparedness.

First Page

209

Last Page

220

Recommended Citation

Lele AV, Wahlster S, Alunpipachathai B, Awraris Gebrewold M, Chou SH, Crabtree G, English S, Der-Nigoghossian C, Gagnon DJ, Kim-Tenser M, Karanjia N, Kirkman MA, Lamperti M, Livesay SL, Mejia-Mantilla J, Melmed K, Prabhakar H, Tumino L, Venkatasubba Rao CP, Udy AA, Videtta W, Moheet AM; NCC-COVID Study Collaborators. Perceptions Regarding the SARS-CoV-2 Pandemic's Impact on Neurocritical Care Delivery: Results From a Global Survey. J Neurosurg Anesthesiol. 2022 Apr 1;34(2):209-220. doi: 10.1097/ANA.0000000000000825. PMID: 34882104; PMCID: PMC8900891.