• World Neurosurg · Jun 2024

    The Effect of the COVID-19 Pandemic on Pituitary Surgeries.

    • Evan Luther, Ian Ramsay, Vaidya Govindarajan, Chandler N Berke, Vivien Makhoul, Martin Merenzon, Katherine Berry, Alexis Morell, Daniel Eichberg, Victor M Lu, Ashish Shah, Ricardo J Komotar, and Michael E Ivan.
    • Department of Neurological Surgery, University of Miami, Miami, Florida, USA.
    • World Neurosurg. 2024 Jun 1; 186: e440e448e440-e448.

    ObjectiveAs the coronavirus disease 2019 (COVID-19) pandemic spread to the United States in 2020, there was an impetus toward postponing or ceasing nonurgent transsphenoidal pituitary surgeries to prevent the spread of the virus. Some centers encouraged transcranial approaches for patients with declining neurologic function. However, no large-scale data exist evaluating the effects that this situation had on national pituitary practice patterns.MethodsPituitary surgeries in the National Inpatient Sample were identified from 2017 to 2020. Surgeries in 2020 were compared with the 3 years previously to determine any differences in demographics, surgical trends/approaches, and perioperative outcomes.ResultsIn 2020, there was a decline in overall pituitary surgeries (34.2 vs. 36.3%; odds ratio (OR), 0.88; P < 0.001) yet transsphenoidal approaches represented a higher proportion of interventions (69.0 vs. 64.9%; P < 0.001). Neurosurgical complications were higher (51.9 vs. 47.4%; OR, 1.13; P < 0.001) and patients were less likely to be discharged home (86.4 vs. 88.5%; OR, 0.84; P < 0.001). This finding was especially true in April 2020 during the first peak in COVID-19 cases, when transcranial approaches and odds of mortality/complications were highest.ConclusionsIn 2020, transsphenoidal surgery remained the preferred approach for pituitary tumor resection despite initial recommendations against the approach to prevent COVID-19 spread. Pituitary surgeries had a higher risk of periprocedural complications despite accounting for preoperative comorbidities, COVID-19 infection status, and surgical approach, suggesting that an overwhelmed hospital system can negatively influence surgical outcomes in noninfected patients.Copyright © 2024 Elsevier Inc. All rights reserved.

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