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Publication Detail
A cohort study of 30 day mortality after NON-EMERGENCY surgery in a COVID-19 cold site.
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Article
  • Authors:
    Kasivisvanathan V, Lindsay J, Rakshani-Moghadam S, Elhamshary A, Kapriniotis K, Kazantzis G, Syed B, Hines J, Bex A, Ho DH, Hayward M, Bhan C, MacDonald N, Clarke S, Walker D, Bellingan G, Moore J, Rohn J, Muneer A, Roberts L, Haddad F, Kelly JD, UCLH study group collaborators
  • Publication date:
    24/10/2020
  • Pagination:
    57, 65
  • Journal:
    Int J Surg
  • Volume:
    84
  • Status:
    Published
  • Country:
    England
  • PII:
    S1743-9191(20)30756-1
  • Language:
    eng
  • Keywords:
    COVID-19, Cancer, Cold site, Mortality, Network, Safety, Surgery
Abstract
BACKGROUND: Two million non-emergency surgeries are being cancelled globally every week due to the COVID-19 pandemic, which will have a major impact on patients and healthcare systems. METHODS: During the peak of the pandemic in the United Kingdom, we set up a multicentre cancer network amongst 14 National Health Service institutions, performing urological, thoracic, gynaecological and general surgical urgent and cancer operations at a central COVID-19 cold site. This is a cohort study of 500 consecutive patients undergoing surgery in this network. The primary outcome was 30-day mortality from COVID-19. Secondary outcomes included all-cause mortality and post-operative complications at 30-days. RESULTS: 500 patients underwent surgery with median age 62.5 (IQR 51-71). 65% were male, 60% had a known diagnosis of cancer and 61% of surgeries were considered complex or major. No patient died from COVID-19 at 30-days. 30-day all-cause mortality was 3/500 (1%). 10 (2%) patients were diagnosed with COVID-19, 4 (1%) with confirmed laboratory diagnosis and 6 (1%) with probable COVID-19. 33/500 (7%) of patients developed Clavien-Dindo grade 3 or higher complications, with 1/33 (3%) occurring in a patient with COVID-19. CONCLUSION: It is safe to continue cancer and urgent surgery during the COVID-19 pandemic with appropriate service reconfiguration.
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