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

Int J Surg. 2020 Dec:84:57-65. doi: 10.1016/j.ijsu.2020.10.019. Epub 2020 Oct 24.

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.

Keywords: COVID-19; Cancer; Cold site; Mortality; Network; Safety; Surgery.

MeSH terms

  • Adult
  • Aged
  • COVID-19 / mortality*
  • Cohort Studies
  • Female
  • Hospital Mortality*
  • Humans
  • Male
  • Middle Aged
  • Oncology Service, Hospital / organization & administration*
  • Pandemics
  • Postoperative Complications / epidemiology
  • SARS-CoV-2
  • State Medicine
  • Surgery Department, Hospital / organization & administration*
  • United Kingdom / epidemiology