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2020 ; 107
(11
): 1440-1449
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Elective surgery cancellations due to the COVID-19 pandemic: global predictive
modelling to inform surgical recovery plans
#MMPMID32395848
ä
Br J Surg
2020[Oct]; 107
(11
): 1440-1449
PMID32395848
show ga
BACKGROUND: The COVID-19 pandemic has disrupted routine hospital services
globally. This study estimated the total number of adult elective operations that
would be cancelled worldwide during the 12?weeks of peak disruption due to
COVID-19. METHODS: A global expert response study was conducted to elicit
projections for the proportion of elective surgery that would be cancelled or
postponed during the 12?weeks of peak disruption. A Bayesian ?-regression model
was used to estimate 12-week cancellation rates for 190 countries. Elective
surgical case-mix data, stratified by specialty and indication (surgery for
cancer versus benign disease), were determined. This case mix was applied to
country-level surgical volumes. The 12-week cancellation rates were then applied
to these figures to calculate the total number of cancelled operations. RESULTS:
The best estimate was that 28?404?603 operations would be cancelled or postponed
during the peak 12?weeks of disruption due to COVID-19 (2?367?050 operations per
week). Most would be operations for benign disease (90·2 per cent, 25?638?922 of
28?404?603). The overall 12-week cancellation rate would be 72·3 per cent.
Globally, 81·7 per cent of operations for benign conditions (25?638?922 of
31?378?062), 37·7 per cent of cancer operations (2?324?070 of 6?162?311) and 25·4
per cent of elective caesarean sections (441?611 of 1?735?483) would be cancelled
or postponed. If countries increased their normal surgical volume by 20 per cent
after the pandemic, it would take a median of 45?weeks to clear the backlog of
operations resulting from COVID-19 disruption. CONCLUSION: A very large number of
operations will be cancelled or postponed owing to disruption caused by COVID-19.
Governments should mitigate against this major burden on patients by developing
recovery plans and implementing strategies to restore surgical activity safely.
|*Models, Statistical
[MESH]
|*Pandemics
[MESH]
|Adult
[MESH]
|Bayes Theorem
[MESH]
|COVID-19/epidemiology/*prevention & control
[MESH]
|Elective Surgical Procedures/*statistics & numerical data
[MESH]
|Global Health
[MESH]
|Health Care Rationing/*statistics & numerical data
[MESH]
|Health Policy
[MESH]
|Health Services Accessibility/*statistics & numerical data
[MESH]