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Showing content from https://pubmed.ncbi.nlm.nih.gov/32395848/ below:

Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans

. 2020 Oct;107(11):1440-1449. doi: 10.1002/bjs.11746. Epub 2020 Jun 13. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans

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PMID: 32395848
PMCID: PMC7272903
DOI: 10.1002/bjs.11746

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Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans

COVIDSurg Collaborative. Br J Surg. 2020 Oct.

. 2020 Oct;107(11):1440-1449. doi: 10.1002/bjs.11746. Epub 2020 Jun 13.

PMID: 32395848
PMCID: PMC7272903
DOI: 10.1002/bjs.11746

Item in Clipboard

Abstract

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 β-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.

Antecedentes: La pandemia de COVID-19 ha interrumpido los servicios hospitalarios habituales a nivel mundial. En este estudio se calculó el número total de operaciones electivas para adultos que se cancelarían en todo el mundo durante las 12 semanas de interrupción máxima debido a COVID’19. MÉTODOS: Se realizó un estudio global de respuestas de expertos para obtener proyecciones sobre la proporción de cirugía electiva que se cancelaría o pospondría durante las 12 semanas del pico máximo de disrupción. Se usó un modelo bayesiano de regresión beta para estimar las tasas de cancelación durante 12 semanas en 190 países. Se determinaron los datos de la casuística de casos quirúrgicos electivos, estratificados por especialidad e indicación (cáncer versus cirugía benigna). Esta casuística de casos se aplicó a volúmenes quirúrgicos a nivel de país. Las tasas de cancelación de las 12 semanas se aplicaron a estas cifras para calcular el total de operaciones suspendidas.

Resultados: La mejor estimación fue que 28.404.603 operaciones hubieran sido canceladas o pospuestas durante las 12 semanas del pico de disrupción por COVID-19 (2.367.050 operaciones por semana). La mayoría hubieran sido operaciones por enfermedad benigna (90,2%, 25.638.922/28. 404. 603). La tasa de cancelación general en 12 semanas sería del 72,3%. A nivel mundial, el 81,7% (25.638.921/31.378.062) de la cirugía benigna, el 37,7% (2. 324.069/6.162.311) de la cirugía por cáncer y el 25,4% (441.611/1.735.483) de las cesáreas electivas hubieran sido canceladas o pospuestas. Si los países aumentan su volumen quirúrgico normal en un 20% después de la pandemia, se tardaría una mediana de 45 semanas para eliminar la acumulación de operaciones resultantes de la disrupción por COVID’19. CONCLUSIÓN: Se cancelará o pospondrá un número muy grande de operaciones debido a la disrupción causada por COVID-19. Los gobiernos deberían mitigar esta importante carga para los pacientes mediante el desarrollo de planes de recuperación e implementando estrategias para reiniciar de manera segura la actividad quirúrgica.

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Graphical Abstract
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Flow chart of methodology

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Flow chart of methodology

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Flow chart of methodology

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Country-level 12-week cancellation rates, by…

Fig. 2

Country-level 12-week cancellation rates, by type of surgery

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Country-level 12-week cancellation rates, by type of surgery

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Best estimates for number of…

Fig. 3

Best estimates for number of elective operations cancelled during the peak 12 weeks…

Fig. 3

Best estimates for number of elective operations cancelled during the peak 12 weeks of disruption due to COVID-19, by geographical region