Planned surgery in the COVID-19 pandemic: a prospective cohort study from Nottingham

Catton, J.; Banerjea, A.; Gregory, S.; Hall, C.; Crooks, Cj; Lewis-Lloyd, Ca; Marshall, A.; Humes, Dj

Abstract

Purpose
Globally planned surgical procedures have been deferred during the current COVID-19 pandemic. The study aimed to report the outcomes of planned urgent and cancer cases during the current pandemic using a multi-disciplinary prioritisation group.

Methods
A prospective cohort study of patients having urgent or cancer surgery at a NHS Trust from 1st March to 30th April 2020 who had been prioritised by a multi-disciplinary COVID Surgery group. Rates of post-operative PCR positive and suspected COVID-19 infections within 30 days, 30-day mortality and any death related to COVID-19 are reported.

Results
Overall 597 patients underwent surgery with a median age of 65 years (interquartile range (IQR) 54–74 years). Of these, 86.1% (514/597) had a current cancer diagnosis. During the period, 60.8% (363/597) of patients had surgery at the NHS Trust whilst 39.2% (234/597) had surgery at Independent Sector hospitals. The incidence of COVID-19 in the East Midlands was 193.7 per 100,000 population during the study period. In the 30 days following surgery, 1.3% (8/597) of patients tested positive for COVID-19 with all cases at the NHS site. Overall 30-day mortality was 0.7% (4/597). Following a PCR positive COVID-19 diagnosis, mortality was 25.0% (2/8). Including both PCR positive and suspected cases, 3.0% (18/597) developed COVID-19 infection with 1.3% at the independent site compared to 4.1% at the NHS Trust (p=0.047).

Conclusions
Rates of COVID-19 infection in the post-operative period were low especially in the Independent Sector site. Mortality following a post-operative diagnosis of COVID-19 was high.

Citation

Catton, J., Banerjea, A., Gregory, S., Hall, C., Crooks, C., Lewis-Lloyd, C., Marshall, A., & Humes, D. (2021). Planned surgery in the COVID-19 pandemic: a prospective cohort study from Nottingham. Langenbeck's Archives of Surgery, 406, 2469-2477. https://doi.org/10.1007/s00423-021-02207-8

• Journal Article Type: Article
• Acceptance Date: May 16, 2021
• Online Publication Date: Jun 15, 2021
• Publication Date: Jun 15, 2021
• Deposit Date: Jun 10, 2021
• Publicly Available Date: Jun 16, 2021
• Journal: Langenbeck's Archives of Surgery
• Print ISSN: 1435-2443
• Electronic ISSN: 1435-2451
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 406
• Pages: 2469-2477
• DOI: https://doi.org/10.1007/s00423-021-02207-8
• Keywords: Upper GI . Lower GI . HPB . COVID-19 . Mortality
• Public URL: https://nottingham-repository.worktribe.com/output/5653695
• Publisher URL: https://link.springer.com/article/10.1007%2Fs00423-021-02207-8