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.
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.
| Original language | English |
|---|---|
| Pages (from-to) | 1440-1449 |
| Number of pages | 10 |
| Journal | British Journal of Surgery |
| Volume | 107 |
| Issue number | 11 |
| Early online date | 12 May 2020 |
| DOIs | |
| Publication status | Published - Oct 2020 |
Bibliographical note
Funding Information:This report was funded by a National Institute for Health Research (NIHR) Global Health Research Unit Grant (NIHR 16.136.79), using UK aid from the UK Government to support global health research; the Association of Coloproctology of Great Britain and Ireland; Bowel & Cancer Research; Bowel Disease Research Foundation; Association of Upper Gastrointestinal Surgeons; British Association of Surgical Oncology; British Gynaecological Cancer Society; European Society of Coloproctology; NIHR Academy; Sarcoma UK; Vascular Society for Great Britain and Ireland; and Yorkshire Cancer Research. The funders had no role in the study design, data collection, analysis and interpretation, or writing of this report. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the UK Department of Health and Social Care.
Publisher Copyright:
© 2020 BJS Society Ltd Published by John Wiley & Sons Ltd
ASJC Scopus subject areas
- Surgery
Access to Document
- COVIDSurg_Collaborative_Elective_surgery_cancellations_due_to_the_COVID_19_pandemic_British_Journal_of_Surgery_2020
This is the peer reviewed version of the following article: CovidSurg Collaborative, Nepogodiev, D. and Bhangu, A., 2020. Elective surgery cancellations due to the COVID‐19 pandemic: global predictive modelling to inform surgical recovery plans. British Journal of Surgery., which has been published in final form at: https://doi.org/10.1002/bjs.11746. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.