1. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans
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Annika Heuer, Abraham Hulst, NTIRENGANYA Faustin, Giacomo Monti, Stephen Choi, Edward J Caruana, Kresimir Oremus, Kathryn Haigh, Amanda Koh, Denis Protsenko, Ana Maria Minaya Bravo, Abegail Salvana, Mahdad Noursadeghi, Rhiannon Harries, Ayyaz Hussain, Sathish Muthu, Professor T E Madiba, Jie Wu, Maria Wittmann, Donaldo S Arteta-Arteta, Mona Momeni, Mary T. Nabukenya, Birender Balain, Irina Paziuk, Matthew Chan, TRIANTAFYLLIA KOUKOUBANI, Gabrielle Van Ramshorst, Gianluca Pellino, Haya Deeb, Daniele Sances, Salomone Di Saverio, Fernando Cordera, Olufemi Bankole, Patrice Forget, Chu Yik Tang, Daniel Conway, Alejandro Suarez de la Rica, E. Christiaan Boerma, Dion Morton, John Edwards, Markus W. Löffler, ANASTASIA SPARTINOU, Daiana Taddeo, VIKAS KAURA, David Choi, Akbar Vohra, Francesco Della Corte, Alexander Durst, Sebastian Tranca, Samuel Ford, Rajkumar Rajendram, Christina Bali, Bosede Afolabi, Nicola Petrucci, Anne Godier, Dmitri Nepogodiev, Rocco D'andrea, Dana Tomescu, Hans Lederhuber, LAURA GAVRIL, Chetan Khatri, Gabriela Droc, Rupert Pearse, Janet Martin, Ari Ercole, Ibironke Desalu, Dejan Radenkovic, Luis Martin-Villen, Alvaro Rea-Neto, Pablo Monedero, Thomas Pinkney, Stuart White, Antonino Spinelli, Manu Malbrain, Bisola Onajin-Obembe, Tom Lawton, Goran Tulic, R. Arthur Bouwman, Shaktiman Singh, Keith Couper, Benedikt Preckel, Osaid Alser, Isabel Gracia, Daniel Cox, Oumaima Outani, Luís Bento, Stephen Webb, Marzida Mansor, Florent Wallet, Konstantinos Stamatiou, Adesoji Ademuyiwa, Bodil Steen Rasmussen, James Glasbey, Nelson Barros, Adewale Adisa, Olanrewaju Akanmu, Ryckie Wade, Joana Berger-Estilita, Stefano Turi, Sigita Kazune, Ewen Harrison, Mihai Stefan, ANTHONY ADENEKAN, Dhruva Ghosh, Sohini Chakrabortee, Mary Venn, Irène Santos, Michael Sander, Vincent Minville, Francisco Javier Redondo Calvo, Naomi Wright, Ismaïl LAWANI, James Haddow, Axel R. Heller, Anders Oldner, Cesar Aldecoa, Savino Spadaro, Robert Parker, Jibril Bello, Tamas Szakmany, Dhruv Parekh, Alberto ZANGRILLO, LUC HUYGHENS, Beatriz Tena, Tom Abbott, Richard Wilkin, Ulrich Goebel, Anca Irina Ristescu, RODRIGO POVES ALVAREZ, Carlos Silva Faria, Hidde M Kroon, José Azevedo, Herman Lule, Orestis Ioannidis, Sandra Jumbe, Peter Hutchinson, Ayaz Ali, Caroline Holaubek, Luke Hopkins, Kirsten Moller, Morten Bestle, Patricia Alfaro de la Torre, Hyla-Louise Kluyts, Evgeny Grigoryev, Shaman Jhanji, Timothy Cook, Carolina Soledad Romero Garcia, Wolfgang Buhre, Denny Levett, Stefan De Hert, Bianchin Andrea, Monir Jawad, Nicoletta Fossati, Matthias Unterberg, Gianluca Castellani, Oliver Warren, Simon Burg, Jose Trenado Álvarez, Franco Ruberto, Adeline Rankin, Arash Afshari, Gerald Ekwen, Helena Barrasa, Andrew Schache, Carlos Ferrando, Johannes Doerner, Hwei Jene Ng, Ruth Blanco-Colino, Sean Ezekiel Seow, Artigas Antonio, Pablo Lozano Lominchar, Dennis Mazingi, Giovanni LANDONI, Martin Hübner, Weng Ken Chan, Hassan Mashbari, Milagros Niquen-Jimenez, Timothy Short, Mikhail Kirov, Alexander Kulikov, Abdulmueti Alhadi, Frederick Van der Merwe, Mahmoud ElFiky, Kai Henrik Wiborg Lange, Gaetano Gallo, Gustavo Mendonça Ataíde Gomes, Aneel Bhangu, Ioana Grigoras, Carlos Serón, Siobhan McKay, Ruth A Benson, Xavier Borrat, Markus Hollmann, Juan José Segura-Sampedro, Devnandan Chatterjee, and Birgitte Brandsborg
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,General surgery ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,Case mix index ,Surgical recovery ,Pandemic ,medicine ,Elective surgery ,Elective Surgical Procedure ,business ,Elective caesarean ,health care economics and organizations ,Predictive modelling - 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.
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- 2020
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