1. The PanSurg-PREDICT Study: Endocrine Surgery During the COVID-19 Pandemic
- Author
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Sahin, Can, Mechera, Robert, Purkayastha, Sanjay, Chander, Nikita, De Jong, Mechteld C, Nandasena, Malith, Baili, Efstratia, Skotsimara, Antonia, Felekouras, Evangelos, Vagios, Ilias, Rooney, Siobhan, Colak, Elif M, Sari, Ahmet Can, Van Den Heede, K, Aybar, Engin, Kara, Yasin, Bozkurt, Mehmet A, Kocataş, Ali, Korkolis, Dimitris P, Leventoglu, Sezai, Altiner, Saygin, Kozan, Ramazan, Parray, Fazl, Chidambaram, Swathikan, Yuksel, Osman, Sare, Mustafa, Balakrishnan, Anita, Bostanci, Hasan, Gobut, Huseyin, Yavuz, Aydin, Markar, Sheraz, Kinross, James K, Di Marco, Aimee N, Kulshreshtha, Ayush, Aseem, Rabiya, Deurloo, Emily K, Yavas, Mesut, Yalcinkaya, Ali, Engelsman, Anton F, Van Berge Henegouwen, Mark I, Quinnen, Nicola C, Karydakis, Lyssandros, Gisbertz, Suzanne S, Cruz, Nina J M DeLa, Voeten, Daan M, Meijer, Floor, Ingwersen, Ewout W, Ali, Alshahrani Mushabab, Magboul, Nasir A, Aziz, Gowhar, Aldaya, Messedah, Mihai, Radu, Yiu, Andrew J, Tolley, N S, Alwade, Hajer, Khan, Natasha, Markiewicz, Ola, Goh, Ee Teng, Denning, Max, Aggarwal, Ravi, Erridge, Simon, Dryden, Simon D, Chidambaram, S, Clarke, Jonathan M, Sounderajah, Viknesh, Kyros, Eleandros, Khan, Shahab, Ayed, Souad, Acharya, Amish, Winter Beatty, J, Rabinowicz, Simon, Collins, Christopher, Mpoura, Maria, Van Den Heede, Klaas, Syllaios, Athanasios, Chowdri, Nisar, Chander, N, Elwahab, Sami A, Roden, Yasmine, Van Dijkum, Els J M Nieveen, Hennessy, Orla, Grewal, Harleen, Nizami, Kulsoom, McKevitt, Kevin, Marzouk, Fadi, O Beirn, Ellen, Ryan, Eanna, van der Hoef, Dayna, Davakis, Spyridon, Murphy, Ben, Chaudhary, Ali, Fradelos, Evangelos, Balalis, Dimitris, Azzam, Ahmed Y, Fowler, Amy, Beatty, Jasmin Winter, Palazzo, Fausto, Liakakos, Theodore, Di Marco, A N, Tolley, Neil, Yalamanchili, Seema, Markar, S, Di Marco, Aimee, Parkins, Kristie, Spencer, Naomi, Egan, Richard J, Martin, Guy, Mason, Sam, Charalabopoulos, Alexandros, Mehraj, Asif, Andrabi, Syed Muzamil, Fulop, Andras, Szijarto, Attila, Shah, Zameer, Bhat, Javeid, Wani, Rauf, Palazzo, F F, Warren, Leigh, Scott, Alasdair J, Azab, Mohammed A, Dhondt, Bert, Glover, Anthony, Burgnon, Elizabeth, Xuan, Rachel, Kinross, J K, Papachristos, Alex, Surgery, CCA - Cancer Treatment and Quality of Life, Amsterdam Gastroenterology Endocrinology Metabolism, and Imperial College Healthcare NHS Trust- BRC Funding
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medicine.medical_specialty ,Original Scientific Report ,medicine.medical_treatment ,Cohort Studies ,Case mix index ,Pandemic ,medicine ,Medicine and Health Sciences ,Humans ,Prospective Studies ,Prospective cohort study ,Pandemics ,Science & Technology ,SARS-CoV-2 ,business.industry ,General surgery ,COVID-19 ,Correction ,1103 Clinical Sciences ,Vascular surgery ,Endocrine surgery ,Cardiothoracic surgery ,PanSurg Collaborative and the PREDICT-Endocrine Collaborative ,Surgery ,business ,Life Sciences & Biomedicine ,Abdominal surgery ,Cohort study - Abstract
Background In the midst of the COVID-19 pandemic, patients have continued to present with endocrine (surgical) pathology in an environment depleted of resources. This study investigated how the pandemic affected endocrine surgery practice. Methods PanSurg-PREDICT is an international, multicentre, prospective, observational cohort study of emergency and elective surgical patients in secondary/tertiary care during the pandemic. PREDICT-Endocrine collected endocrine-specific data alongside demographics, COVID-19 and outcome data from 11–3-2020 to 13–9-2020. Results A total of 380 endocrine surgery patients (19 centres, 12 countries) were analysed (224 thyroidectomies, 116 parathyroidectomies, 40 adrenalectomies). Ninety-seven percent were elective, and 63% needed surgery within 4 weeks. Eight percent were initially deferred but had surgery during the pandemic; less than 1% percent was deferred for more than 6 months. Decision-making was affected by capacity, COVID-19 status or the pandemic in 17%, 5% and 7% of cases. Indication was cancer/worrying lesion in 61% of thyroidectomies and 73% of adrenalectomies and calcium 2.80 mmol/l or greater in 50% of parathyroidectomies. COVID-19 status was unknown at presentation in 92% and remained unknown before surgery in 30%. Two-thirds were asked to self-isolate before surgery. There was one COVID-19-related ICU admission and no mortalities. Consultant-delivered care occurred in a majority (anaesthetist 96%, primary surgeon 76%). Post-operative vocal cord check was reported in only 14% of neck endocrine operations. Both of these observations are likely to reflect modification of practice due to the pandemic. Conclusion The COVID-19 pandemic has affected endocrine surgical decision-making, case mix and personnel delivering care. Significant variation was seen in COVID-19 risk mitigation measures. COVID-19-related complications were uncommon. This analysis demonstrates the safety of endocrine surgery during this pandemic.
- Published
- 2021