Please use this identifier to cite or link to this item: https://doi.org/10.1007/s00586-020-06679-y
Title: A novel hospital capacity versus clinical justification triage score (CCTS) for prioritization of spinal surgeries in the "new normal state" of the COVID-19 pandemic
Authors: Liu, Gabriel
Tan, Jun-Hao 
Hey, Hwee Weng Dennis 
Lau, Leok Lim 
Thambiah, Joseph 
Kumar, Naresh 
Tan, Jonathan
Ruiz, John
Nga, Vincent
Lwin, Sein
Teo, Kejia 
Ning, Chou
Agrawal, Rohit Vijay 
NG, Bryan
Wong, Weng Hoa 
Yeo, Tseng Tsai
Wong, Hee-Kit 
Keywords: Science & Technology
Life Sciences & Biomedicine
Clinical Neurology
Orthopedics
Neurosciences & Neurology
COVID-19
Scoring system
Prioritization of surgery
Delphi technique
Resource utilization
VISUAL ANALOG SCALE
CLASSIFICATION
PAIN
GUIDELINES
MANAGEMENT
SEVERITY
INJURIES
SYSTEM
ETHICS
Issue Date: 2-Jan-2021
Publisher: SPRINGER
Citation: Liu, Gabriel, Tan, Jun-Hao, Hey, Hwee Weng Dennis, Lau, Leok Lim, Thambiah, Joseph, Kumar, Naresh, Tan, Jonathan, Ruiz, John, Nga, Vincent, Lwin, Sein, Teo, Kejia, Ning, Chou, Agrawal, Rohit Vijay, NG, Bryan, Wong, Weng Hoa, Yeo, Tseng Tsai, Wong, Hee-Kit (2021-01-02). A novel hospital capacity versus clinical justification triage score (CCTS) for prioritization of spinal surgeries in the "new normal state" of the COVID-19 pandemic. EUROPEAN SPINE JOURNAL 30 (5) : 1247-1260. ScholarBank@NUS Repository. https://doi.org/10.1007/s00586-020-06679-y
Abstract: Introduction: During the Coronavirus disease 2019 outbreak, while healthcare systems and hospitals are diverting their resources to combat the pandemic, patients who require spinal surgeries continue to accumulate. The aim of this study is to describe a novel hospital capacity versus clinical justification triage score (CCTS) to prioritize patients who require surgery during the “new normal state” of the COVID-19 pandemic. Methodology: A consensus study using the Delphi technique was carried out among clinicians from the Orthopaedic Surgery, Neurosurgery, and Anaesthesia departments. Three rounds of consensus were carried out via survey and Webinar discussions. Results: A 50-points score system consisting of 4 domains with 4 subdomains was formed. The CCTS were categorized into the hospital capacity, patient factors, disease severity, and surgery complexity domains. A score between 30 and 50 points indicated that the proposed operation should proceed without delay. A score of less than 20 indicates that the proposed operation should be postponed. A score between 20 and 29 indicates that the surgery falls within a grey area where further discussion should be undertaken to make a joint justification for approval of surgery. Conclusion: This study is a proof of concept for the novel CCTS scoring system to prioritize surgeries to meet the rapidly changing demands of the COVID-19 pandemic. It offers a simple and objective method to stratify patients who require surgery and allows these complex and difficult decisions to be unbiased and made transparently among surgeons and hospital administrators.
Source Title: EUROPEAN SPINE JOURNAL
URI: https://scholarbank.nus.edu.sg/handle/10635/207198
ISSN: 09406719
14320932
DOI: 10.1007/s00586-020-06679-y
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