Views provided by UsageCountsElective Cancer Surgery in COVID-19–Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study
Copyright policy ) James C. Glasbey; Dmitri Nepogodiev; Joana F.F. Simoes; Omar Omar; Elizabeth Li; Mary L. Venn; null PGDME; +193 Authors
James C. Glasbey; Dmitri Nepogodiev; Joana F.F. Simoes; Omar Omar; Elizabeth Li; Mary L. Venn; null PGDME; Mohammad K. Abou Chaar; Vita Capizzi; Daoud Chaudhry; Anant Desai; Jonathan G. Edwards; Jonathan P. Evans; Marco Fiore; Jose Flavio Videria; Samuel J. Ford; Ian Ganly; Ewen A. Griffiths; Rohan R. Gujjuri; Angelos G. Kolias; Haytham M.A. Kaafarani; Ana Minaya-Bravo; Siobhan C. McKay; Helen M. Mohan; Keith J. Roberts; Carlos San Miguel-Méndez; Peter Pockney; Richard Shaw; Neil J. Smart; Grant D. Stewart; Sudha Sundar, MRCOG; Raghavan Vidya; Aneel A. Bhangu; James C Glasbey; Dmitri Nepogodiev; Joana FF Simoes; Omar Omar; Elizabeth Li; Mary L Venn; Mohammad Abou Chaar; Vita Capizzi; Daoud Chaudhry; Anant Desai; Jonathan G Edwards; Jonathan P Evans; Marco Fiore; Jose Flavio Videria; Samuel J Ford; Ian Ganyli; Ewen A Griffiths; Rohan R Gujjuri; Angelos G Kolias; Haytham MA Kaafarani; Ana Minaya-Bravo; Siobhan C McKay; Helen M Mohan; Keith Roberts; Carlos San Miguel-Méndez; Peter Pockney; Richard Shaw; Neil J Smart; Grant D Stewart; Sudha Sundar; Raghavan Vidya; Aneel A Bhangu; James C Glasbey; Omar Omar; Aneel A Bhangu; Kwabena Siaw-Acheampong; Ruth A Benson; Edward Bywater; Daoud Chaudhry; Brett E Dawson; Jonathan P Evans; James C Glasbey; Rohan R Gujjuri; Emily Heritage; Conor S Jones; Sivesh K Kamarajah; Chetan Khatri; Rachel A Khaw; James M Keatley; Andrew Knight; Samuel Lawday; Elizabeth Li; Harvinder S Mann; Ella J Marson; Kenneth A McLean; Siobhan C McKay; Emily C Mills; Dmitri Nepogodiev; Gianluca Pellino; Maria Picciochi; Elliott H Taylor; Abhinav Tiwari; Joana FF Simoes; Isobel M Trout; Mary L Venn; Richard JW Wilkin; Aneel A Bhangu; James C Glasbey; Neil J Smart; Ana Minaya-Bravo; Jonathan P Evans; Gaetano Gallo; Susan Moug; Francesco Pata; Peter Pockney; Salomone Di Saverio; Abigail Vallance; Dale Vimalchandran; Ewen A Griffiths; Sivesh K Kamarajah; Richard PT Evans; Philip Townend; Keith Roberts; Siobhan McKay; John Isaac; Sohei Satoi; John Edwards; Aman S Coonar; Adrian Marchbank; Edward J Caruana; Georgia R Layton; Akshay Patel; Alessandro Brunelli; Samuel Ford; Anant Desai; Alessandro Gronchi; Marco Fiore; Max Almond; Fabio Tirotta; Sinziana Dumitra; Angelos Kolias; Stephen J Price; Daniel M Fountain; Michael D Jenkinson; Peter Hutchinson; Hani J Marcus; Rory J Piper; Laura Lippa; Franco Servadei; Ignatius Esene; Christian Freyschlag; Iuri Neville; Gail Rosseau; Karl Schaller; Andreas K Demetriades; Faith Robertson; Alex Alamri; Richard Shaw; Andrew G Schache; Stuart C Winter; Michael Ho; Paul Nankivell; Juan Rey Biel; Martin Batstone; Ian Ganly; Raghavan Vidya; Alex Wilkins; Jagdeep K Singh; Dinesh Thekinkattil; Sudha Sundar; Christina Fotopoulou; Elaine Leung; Tabassum Khan; Luis Chiva; Jalid Sehouli; Anna Fagotti; Paul Cohen; Murat Gutelkin; Rahel Ghebre; Thomas Konney; Rene Pareja; Rob Bristow; Sean Dowdy; TS Shylasree; R Kottayasamy Seenivasagam; Joe Ng; Keiiji Fujiwara; Grant D Stewart; Benjamin Lamb; Krishna Narahari; Alan McNeill; Alexandra Colquhoun; John McGrath; Steve Bromage; Ravi Barod; Veeru Kasivisvanathan; Tobias Klatte; Joana FF Simoes; Tom EF Abbott; Sadi Abukhalaf; Michel Adamina; Adesoji O Ademuyiwa; Arnav Agarwal; Murat Akkulak; Ehab Alameer; Derek Alderson; Felix Alakaloko;
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Elective Cancer Surgery in COVID-19–Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study
PURPOSEAs cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway.PATIENTS AND METHODSThis international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation).RESULTSOf 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76).CONCLUSIONWithin available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks.
- Royal Devon University Healthcare NHS Foundation Trust United Kingdom
- Wrocław Medical University Poland
- University of Melbourne Australia
- University of Lille France
- Imperial College London United Kingdom
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Male, International Cooperation, cohort studies, middle aged, 80 and over, Lung, Cancer, COVID-19/epidemiology, Aged, 80 and over, Covid-19 Elective cancer, OUTCOMES, General Medicine, /dk/atira/pure/subjectarea/asjc/2700/2730, Critical Care/*methods, aged, N/A, Oncology, Elective Surgical Procedures, Pneumonia & Influenza, COVID 19, Human, Logistic Model, Aged; Aged; 80 and over; COVID-19; Cohort Studies; Critical Care; Elective Surgical Procedures; Epidemics; Female; Humans; International Cooperation; Logistic Models; Male; Middle Aged; Neoplasms; Outcome Assessment; Health Care; Postoperative Complications; SARS-CoV-2, Clinical Sciences, Epidemic, 610, ., Article, [SDV.CAN] Life Sciences [q-bio]/Cancer, Clinical Research, 616, Humans, Epidemics, Aged, Science & Technology, COVID-19/epidemiology/*prevention & control/virology, Elective Surgical Procedure, Prevention, Oncology and carcinogenesis, Pneumonia, Neoplasms/*surgery, Aged; Aged, 80 and over; COVID-19; Cohort Studies; Critical Care; Elective Surgical Procedures; Epidemics; Female; Humans; International Cooperation; Logistic Models; Male; Middle Aged; Neoplasms; Outcome Assessment, Health Care; Postoperative Complications; SARS-CoV-2;, ResearchInstitutes_Networks_Beacons/mcrc; name=Manchester Cancer Research Centre, Postoperative Complications/*prevention & control/virology, Health Care, neoplasms/surgery, Logistic Models, critical care/methods, Surgery, SARS-CoV-2 pandemic, Postoperative Complication, aged, 80 and over, SARS-CoV-2/physiology, logistic models, health care/methods, Outcome Assessment, name=Cancer Research, Clinical sciences, Elective Surgical Procedures/*methods, Aged; Aged, 80 and over; COVID-19; Cohort Studies; Critical Care; Elective Surgical Procedures; Epidemics; Female; Humans; International Cooperation; Logistic Models; Male; Middle Aged; Neoplasms; Outcome Assessment, Health Care; Postoperative Complications; SARS-CoV-2, Cohort Studies, Postoperative Complications, Neoplasms, Outcome Assessment, Health Care, Aged; Aged, 80 and over; Cohort Studies; COVID-19; Critical Care; Elective Surgical Procedures; Epidemics; Female; Humans; International Cooperation; Logistic Models; Male; Middle Aged; Neoplasms; Outcome Assessment, Health Care; Postoperative Complications; SARS-CoV-2, Manchester Cancer Research Centre, Settore MEDS-15/A - Neurochirurgia, Health Care/methods/statistics & numerical data, Middle Aged, Female, Patient Safety, cancer surgery, /dk/atira/pure/subjectarea/asjc/1300/1306, 6.4 Surgery, Life Sciences & Biomedicine, elective surgical procedures/methods, Critical Care, Oncology and Carcinogenesis, epidemics, cancer surgery ; COVID-19 ; SARS-CoV-2 pandemic, COVIDSurg Collaborative, outcome assessment, health care/methods, male, 1112 Oncology and Carcinogenesis, Oncology & Carcinogenesis, outcome assessment, SARS-CoV-2, name=Oncology, Evaluation of treatments and therapeutic interventions, COVID-19, 1103 Clinical Sciences, Good Health and Well Being, Neoplasm, postoperative complications/prevention & control, Cohort Studie
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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
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This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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