Article ; Online: Is a "COVID-19-free" hospital the answer to resuming elective surgery during the current pandemic? Results from the first available prospective study.
2020 Volume 168, Issue 4, Page(s) 572–577
Abstract: Background: Resumption of elective surgery during the current coronavirus disease 2019 pandemic crisis has been debated widely and largely discouraged. The aim of this prospective cohort study was to assess the feasibility of resuming elective ... ...
| Abstract | Background: Resumption of elective surgery during the current coronavirus disease 2019 pandemic crisis has been debated widely and largely discouraged. The aim of this prospective cohort study was to assess the feasibility of resuming elective operations during the current and possible future peaks of this coronavirus disease 2019 pandemic. Methods: We collected data during the peak of the current pandemic in the United Kingdom on adult patients who underwent elective surgery in a "COVID-19-free" hospital from April 8 to May 29, 2020. The study included patients from various surgical specialties. Nonelective and pediatric cases were excluded. The primary outcome was 30-day mortality postoperatively. Secondary outcomes were the rate of coronavirus disease 2019 infections, new onset of pulmonary symptoms after hospitalization, and requirement for admission to the intensive care unit. Results: A total of 309 consecutive adult patients were included in this study. No patients died nor required intensive care unit admission. Operations graded "Intermediate" were the most performed procedure representing 91% of the total number. One patient was diagnosed with a coronavirus disease 2019 infection after being transferred to the nearest local emergency hospital for management of postoperative pain secondary to common bile duct stone and was successfully treated conservatively on the ward. No patient developed pulmonary complications. Three patients were admitted for greater than 23 hours. Twenty-seven patients (8.7%) developed complications. Complications graded as 2 and 3 according to the Clavien-Dindo classification occurred in 14 and 2 patients, respectively. Conclusion: This prospective study shows that, despite the severity and high transmissibility of novel coronavirus 2 disease, COVID-19-free hospitals can represent a safe setting to resume many types of elective surgery during the peak of a pandemic. |
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| MeSH term(s) | Adult ; Aged ; Betacoronavirus/isolation & purification ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques/standards ; Clinical Laboratory Techniques/statistics & numerical data ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; Elective Surgical Procedures/adverse effects ; Elective Surgical Procedures/standards ; Feasibility Studies ; Female ; Hospital Mortality ; Humans ; Infection Control/standards ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Infectious Disease Transmission, Professional-to-Patient/prevention & control ; Intensive Care Units/statistics & numerical data ; Male ; Middle Aged ; Pandemics/prevention & control ; Patient Admission/standards ; Patient Admission/statistics & numerical data ; Patient Selection ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Prospective Studies ; SARS-CoV-2 ; Treatment Outcome ; United Kingdom/epidemiology |
| Keywords | covid19 |
| Language | English |
| Publishing date | 2020-07-15 |
| Publishing country | United States |
| Document type | Journal Article ; Observational Study |
| ZDB-ID | 202467-6 |
| ISSN | 1532-7361 ; 0039-6060 |
| ISSN (online) | 1532-7361 |
| ISSN | 0039-6060 |
| DOI | 10.1016/j.surg.2020.07.003 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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