The impact of COVID-19 on neurosurgical theatre activity in the National Neurosurgical Centre of Ireland

Background: The global healthcare activity including neurosurgical services has been significantly impacted by the COVID-19 pandemic.

Aim: Compare neurosurgical theatre activity from 2019 (pre-pandemic) to that of the subsequent pandemic years (2020-2021) and explore how each wave of COVID-19 infection impacted activity levels.

Methods: A retrospective analysis of neurosurgical theatre activity at the National Neurosurgical Centre of Ireland was performed from 1 January 2019 till 31 December 2021. The extracted data included date, surgical procedure, demographics of the patient and case scheduling (elective or emergency).

Results: In total, 6139 neurosurgical procedures were recorded throughout the study period. Two thousand one hundred forty-four neurosurgical procedures were recorded in 2019, 2052 in 2020 and 1943 in 2021 corresponding to a reduction in theatre activity by 4.3% and 9.4% in 2020 and 2021 respectively. The lowest number of monthly caseloads was recorded in April 2020 during the first wave of the pandemic. The first quarter of 2021 recorded the lowest number of quarterly surgical procedures over the entire 3-year period contributing to just 19.4% of 2021 caseload. Subgroup analysis showed a significant reduction in trans-sphenoidal pituitary surgeries post-pandemic by 36% and 44% in 2020 and 2021 respectively.

Conclusions: Despite the exceptional stress imposed on our institution by COVID-19, the neurosurgical service managed to maintain comparable activity levels to 2019. The 2021 activity levels were more significantly impacted with 9.4% reduction when compared with pre-pandemic figures in 2019. Institutions need to develop a robust emergency plan to reduce the impact of any subsequent pandemics on healthcare delivery.