key: cord-0709905-oeqmh20j
authors: Laxpati, Nealen G; Chern, Joshua J
title: In Reply: Unexpected Decrease in Shunt Surgeries Performed During the Shelter-in-Place Period of the COVID-19 Pandemic
date: 2021-06-30
journal: Oper Neurosurg (Hagerstown)
DOI: 10.1093/ons/opab255
sha: 649275ff6ecfaee97541ec66f18dd80689e1534d
doc_id: 709905
cord_uid: oeqmh20j

nan

the study period, as well as subsequent years, would better characterize our observations. To that end, we first explored the number of shunt surgeries over the 6-mo period starting March of 2020 ( Figure 1 ). After the nidus in March, we did not see a sharp increase in the number of urgent shunt revisions being performed. Instead, we see a steady increase in the number of shunt revisions back to our institutional baseline over months, with some weekto-week variation. In Georgia, the lifting of restrictions was a gradual process that started on April 27, 2020, where the governor began lifting restrictions on certain businesses (gyms, bowling alleys, body art studios), but all restrictions were not lifted until May 3, 2021. Next, we examined the equivalent study period 2 | VOLUME 0 | NUMBER 0 | 2021 www.operativeneurosurgery-online.com CORRESPONDENCE factors can have profound influence, and make retrospective evaluation difficult. Care must be taken in drawing definitive conclusions from these data. Despite this, it appears that the decrease in shunt surgeries during the shelter-in-place period of the COVID-19 pandemic was not simply due to delays in presentation, as these "missing" shunts were not suddenly made up in the subsequent weeks and months of 2020. Instead, the steady increase in rate back to our baseline supports the hypothesis that environmental factors and perception of the dangers of presenting to an emergency room during the pandemic may have a significant influence on presentation. There appears to be a correlation between the easing of restrictions, comfort with presenting to hospitals for emergency care, and the rate of shunt surgeries at our institution. Whether this is truly a causal relationship is difficult to determine, but the implication is that environmental factors may play a greater role in presentation than previously understood, and that a significant proportion of shunt surgeries may be driven by patient and family behavior rather than neurological necessity.

This study did not receive any funding or financial support.

Letter: unexpected decrease in shunt surgeries performed during the shelter-in-place period of the COVID-19 pandemic

Unexpected decrease in shunt surgeries performed during the shelter-in-place period of the COVID-19 pandemic

COVID-19: changing patterns among neurosurgical patients from North India, efficacy of repeat testing, and inpatient prevalence

The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.