engleski

Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans

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 (cancer versus benign surgery), was determined. This case- mix was applied to country-level surgical volumes. The 12-week cancellation rates were then applied to these figures to calculate total 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%, 25, 638, 922/28, 404, 603). The overall 12-week cancellation rate would be 72.3%. Globally, 81.7% (25, 638, 921/31, 378, 062) of benign surgery, 37.7% (2, 324, 069/6, 162, 311) of cancer surgery, and 25.4% (441, 611/1, 735, 483) of elective Caesarean sections would be cancelled or postponed. If countries increase their normal surgical volume by 20% post-pandemic, it would take a median 45 weeks to clear the backlog of operations resulting from COVID-19 disruption. Conclusions A very large number of operations will be cancelled or postponed due to disruption caused by COVID-19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to safely restore surgical activity.

SARS‐CoV‐2 ; COVID‐19 ; elective surgery ; cancellation

COVIDSurg Collaborative / EUSOS Site Investigators (*means Local lead Investigator): Croatia: National Co-ordinators: Tatjana Goranović, Branka Mazul-Sunko (University Hospital Sveti Duh Zagreb). Akromion Special Hospital for Orthopaedic Surgery: Krapinske Toplice, Krešimir Oremuš*. University Hospital Dubrava Zagreb: Gabrijela Bešlić, Viktor Duzel*, Ada Hauptman, Sanja Peremin, Andrej Šribar, Miroslav Župčić. General Hospital Dr Josip Benčević: Slavonski Brod, Ivan Mirković*. General Hospital Karlovac: Zlata Šarić Bauer, Matija Belavić, Božidar Blažanin, Mirjana Lončarić Katušin, Antonija Brozović Krijan, Petar Mišković, Nataša Šimić-Korać, Jasna Topić, Antonio Žilić*, Josip Žunić University Hospital Merkur Zagreb: Ivana Acan, Mirta Adanić, Nikola Ivanov, Jadranka Pavičić Šarić*, Katarina Tomulić, Nataša Visković. University Hospital Center Osijek: Silvana Bošnjak, Ivana Haršanji Drenjančevic*, Gordana Kristek, Slavica Kvolik, Stela Markić, Andreja Stojanovic Rakipovic, Ozana Katarina Tot, Darija Venzera- Azenic. General Hospital Pula: Lada Kalagac Fabris*. University