Author, as appears in the article.: Glasbey, James C.; Nepogodiev, Dmitri; Simoes, Joana F. F.; Omar, Omar; Li, Elizabeth; Venn, Mary L.; Abou Chaar, Mohammad K.; Capizzi, Vita; Chaudhry, Daoud; Desai, Anant; Edwards, Jonathan G.; Evans, Jonathan P.; Fiore, Marco; Videria, Jose Flavio; Ford, Samuel J.; Ganly, Ian; Griffiths, Ewen A.; Gujjuri, Rohan R.; Kolias, Angelos G.; Kaafarani, Haytham M. A.; Minaya-Bravo, Ana; McKay, Siobhan C.; Mohan, Helen M.; Roberts, Keith J.; San Miguel-Mendez, Carlos; Pockney, Peter; Shaw, Richard; Smart, Neil J.; Stewart, Grant D.; Sundar, Sudha; Vidya, Raghavan; Bhangu, Aneel A.; COVIDSurg Collaborative

Department: Medicina i Cirurgia

URV's Author/s: Jorba Martin, Rosa Maria

Keywords: Surgery

Abstract: PURPOSE As 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 METHODS This 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). RESULTS Of 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). CONCLUSION Within 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.

Thematic Areas: Saúde coletiva Oncology Medicine (miscellaneous) Medicina iii Medicina ii Medicina i Matemática / probabilidade e estatística Interdisciplinar General medicine Farmacia Ciências biológicas ii Ciências biológicas i Cancer research Biotecnología

licence for use: https://creativecommons.org/licenses/by/3.0/es/

Author's mail: rosamaria.jorba@urv.cat

Author identifier: 0000-0003-3307-4340

Record's date: 2023-02-23

Papper version: info:eu-repo/semantics/publishedVersion

Link to the original source: https://ascopubs.org/doi/10.1200/JCO.20.01933

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: Journal Of Clinical Oncology. 39 (1): 66-78

APA: Glasbey, James C.; Nepogodiev, Dmitri; Simoes, Joana F. F.; Omar, Omar; Li, Elizabeth; Venn, Mary L.; Abou Chaar, Mohammad K.; Capizzi, Vita; Chaudhry (2021). Elective cancer surgery in Covid-19-free surgical pahtways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study. Journal Of Clinical Oncology, 39(1), 66-78. DOI: 10.1200/JCO.20.01933

Article's DOI: 10.1200/JCO.20.01933

Entity: Universitat Rovira i Virgili

Journal publication year: 2021

Publication Type: Journal Publications