Effect of the SARS-CoV-2 pandemic on mortality related to high-risk emergency and major elective surgery

Abstract

These data show large reductions in both elective and emergency activity that are concerning for unmeasured morbidity and mortality within the community. The risk of mortality following high-risk EGS and major elective surgery during the first wave of the pandemic did not differ when compared with date-matched patient cohorts from 2019. The prevalence of concomitant SARS-CoV-2 infection in this surgical population is low.

Impact of two waves of Sars‐Cov2 outbreak on the number, clinical presentation, care trajectories and survival of patients newly referred for a colorectal cancer: A French multicentric cohort study from a large group of university hospitals

“…These results suggest that the statistically significant decrease in OS noticed between new CRC patients undergoing any kind of anticancer treatment in 2020 compared to the two previous years is explained by Sars Cov2 infection more than by the impact of the pandemic on CRC care delivery. This is consistent with English data showing no significant difference in mortality risk after major surgeries between 2019 and 2020, but a significantly higher risk of mortality for patients with Sars Cov2 infection 44 . Previous modeling studies focusing on CRC‐related mortality have anticipated a 15 000 quality‐adjusted life years loss in the UK and between 1445 and 1563 extra deaths due to the pandemic restrictions in the 5 years after diagnosis 20,45 …”

“…This is consistent with English data showing no significant difference in mortality risk after major surgeries between 2019 and 2020, but a significantly higher risk of mortality for patients with Sars Cov2 infection. 44 Previous modeling studies focusing on CRC-related mortality have anticipated a 15 000 qualityadjusted life years loss in the UK and between 1445 and 1563 extra deaths due to the pandemic restrictions in the 5 years after diagnosis. 20,45 Among the study strengths, this is the largest published study…”

The use of, and outcomes for, inflammatory bowel disease services during the Covid‐19 pandemic: a nationwide observational study

“…It is unclear if IBD patients had excess mortality in the community during the first wave. Admissions for ischaemic heart disease and high‐risk emergency general surgery did decrease during the first wave of the pandemic, giving indirect evidence that out of hospital deaths may have increased 1,2 …”

“…Admissions for ischaemic heart disease and high-risk emergency general surgery did decrease during the first wave of the pandemic, giving indirect evidence that out of hospital deaths may have increased. 1,2 The evidence regarding UC colectomy rates in recent years is conflicting. Some studies suggest that colectomy rate is decreasing in the era of access to biologic medications.…”

What happened to English NHS hospital activity during the COVID-19 pandemic?

“…1 The use of patient-level data allows us to explore in detail how different types of care changed and how this varied across groups. This detailed focus complements previous work that examined trends in national activity across a range of NHS services (see, for example, Thorlby, Fraser and Gardner (2020), Gardner and Fraser (2021) and Deputy et al (2021)). 2 We focus on the 10-month period from March to December in 2020 and 2019, and on changes in the number of elective (planned) and emergency inpatient admissions, and outpatient appointments.…”