engleski

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS- CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351 ; best case 196, worst case 816) or non-cancer surgery (733 ; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840 ; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19- related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.

SARS-CoV-2 ; vaccination ; safe surgery

Dissemination Committee (alphabetical by country): Croatia: Ana Danić Hadžibegović, Tomislav Kopjar, Jakov Mihanović Local Collaborators: Croatia: Kristina Bitunjac, Karlo Grulović, Marijana Vučković (General and Veterans Hospital ‘Hrvatski Ponos’ Knin, Knin); Goran Šantak (County General Hospital Pozega, Pozega); Emanuel Borovic, Ana Bosak Versic, Damir Hasandić, Natasa Poldan Grabar, Suzana Srsen Medancic (University Hospital Center Rijeka, Rijeka); Lucija Brkic, Sara Cokarić, Petra Pavic Palac, Zeljka Samac, Josipa Tomić, Marija Vrdoljak (General Hospital Sibenik, Sibenik); Ivan Bacic, Bernarda Bakmaz, Nikolina Bratošević Vučičić, Domagoj Brzic, Samir Canovic, Emilio Dijan, Maja Grgec Dragicevic, Robert Karlo, Suzana Konjevoda, Petra Kovačević, Ivan Kovačić, Frane Markulić, Luka Matak, Jakov Mihanovic, Domagoj Morović, Gordan Perišić, Andrea Simic, Neven Skitarelić, Matea Veršić, Vanja Žufić, Matea Zuzul (Zadar General Hospital, Zadar); Srdan Ante Anzic, Iva Carevic, Dubravka Heli Litvic, Duska Markov- Glavas, Tatjana Savic Jovanovic (Children’s Hospital Srebrnjak, Zagreb); Goran