• Int J Surg · Dec 2020

    A cohort study of 30 day mortality after NON-EMERGENCY surgery in a COVID-19 cold site.

    • Veeru Kasivisvanathan, Jamie Lindsay, Sara Rakshani-Moghadam, Ahmed Elhamshary, Konstantinos Kapriniotis, Georgios Kazantzis, Bilal Syed, John Hines, Axel Bex, Daniel Heffernan Ho, Martin Hayward, Chetan Bhan, Nicola MacDonald, Simon Clarke, David Walker, Geoff Bellingan, James Moore, Jennifer Rohn, Asif Muneer, Lois Roberts, Fares Haddad, John D Kelly, and UCLH study group collaborators.
    • Department of Urology, University College London Hospital NHS Foundation Trust, London, UK; Division of Surgery and Interventional Science, University College London, London, UK. Electronic address: veeru.kasi@ucl.ac.uk.
    • Int J Surg. 2020 Dec 1; 84: 57-65.

    BackgroundTwo 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.MethodsDuring 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.Results500 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.ConclusionIt is safe to continue cancer and urgent surgery during the COVID-19 pandemic with appropriate service reconfiguration.Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.

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