A cohort study of 30 day mortality after NON-EMERGENCY surgery in a COVID-19 cold site
Veeru Kasivisvanathan, Jamie Lindsay, Sara Rakshani-Moghadam, A Elhamshary, Konstantinos Kapriniotis, Georgios Kazantzis, Bilal Syed, John Hines, Axel Bex, Daniel Ho, Martin Hayward, Chetan Bhan, Nicola MacDonald, Simon Clarke, David Walker, Geoff Bellingan, James Moore, Jennifer Rohn, Asıf Muneer, Lois Roberts, Fares S. Haddad, John D. Kelly, Tarek Ezzatt Abdel-Aziz, Clare Allen, Siân Allen, Hussain M. Alnajjar, Daniella E. Andrich, Vimoshan Arumuham, Naaila Aslam, Ravi Barod, Rosie Batty, Timothy Briggs, Eleanor C. Brockbank, Manish Chand, Simon Choong, Nim Christopher, Justin Collins, James Crosbie, Louise Dickinson, Konstantinos Doufekas, Mark Feneley, Tamsin Greenwell, Alistair Grey, Rizwan Hamid, John Hines, Julie Jenks, Arjun Jeyarajah, D. Jurkovic, Anand Kelkar, Ioannis Kotsopoulos, Tomasz R. Kurzawinski, David Lawrence, Chi‐Ying Li, Robert M. May, Jonathan McCullough, Sofoklis Mitsos, Caroline M. Moore, Tim Mould, Anthony R. Mundy, Senthil Nathan, Robert Nicolae, Jeremy Ockrim, Adeola Olaitan, Clément Orczyk, Mahreen Pakzad, Nikolaos Panagiotopoulos, Prasad Patki, Davide Patrini, Douglas Pendsé, Saurabh Phadnis, Prabhakar Rajan, David Ralph, Tommy Rampling, Pippa Sangster, Greg Shaw, Daron Smith, Prasanna Sooriakumaran, Ashwin Sridhar, Tom Strange, Maxine Tran, Dimitrios Volanis, Dan Wood, Christopher Wood
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.