Elective surgery cancellations due to theCOVID-19 pandemic: global predictive modelling to inform surgical recovery plans
Elective surgery cancellations due to theCOVID-19 pandemic: global predictive modelling to inform surgical recovery plans
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DOI：
10.1002/bjs.11746
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发表时间：
2020-06-13
影响因子：
9.6
通讯作者：
Poelaert, Jan
中科院分区：
文献类型：
--
作者：
Nepogodiev, D.;Omar, Omar M.;Poelaert, Jan
背景COVID-19大流行扰乱了全球的常规医院服务。这项研究估计了在COVID-19造成的12周高峰中断期间，全球将取消的成人择期手术总数。方法进行了一项全球专家响应研究，以预测在12周的高峰中断期间将取消或推迟的择期手术比例。使用贝叶斯β回归模型估计了190个国家的12周取消率。根据专业和适应症（癌症手术与良性疾病手术）分层，确定了择期手术病例组合数据。该病例组合适用于国家级手术量。然后将12周的取消率应用于这些数字，以计算取消的行动总数。结果最佳估计是，28 404 603例手术将在COVID-19导致的12周中断高峰期间被取消或推迟（每周2 367 050例手术）。大多数将是良性疾病的手术（90个中心点2%，28 404 603中的25 638 922）。12周的整体取消率将为72%，全球范围内，81%的运营是良性的（25 638 922，共31 378 062），37个中心点7%的癌症手术（2 324 070例，共6 162 311例）和25个中心点4%的选择性剖腹产（441 611例，共1 735 483例）将被取消或推迟。如果各国在大流行后将正常手术量增加20%，则需要平均45周的时间来清理因COVID-19中断而积压的手术。由于COVID-19造成的中断，大量手术将被取消或推迟。各国政府应通过制定恢复计划和实施安全恢复手术活动的战略来减轻患者的这一重大负担。
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 beta-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 cancerversusbenign 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 center dot 2 per cent, 25 638 922 of 28 404 603). The overall 12-week cancellation rate would be 72 center dot 3 per cent. Globally, 81 center dot 7 per cent of operations for benign conditions (25 638 922 of 31 378 062), 37 center dot 7 per cent of cancer operations (2 324 070 of 6 162 311) and 25 center dot 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.