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

COVIDSurg Collaborative, GlobalSurg Collaborative (2021). SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study. British journal of surgery, 108(9), pp. 1056-1063. John Wright & Sons 10.1093/bjs/znab101

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Thoracic Surgery

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0007-1323

Publisher:

John Wright & Sons

Language:

English

Submitter:

Thomas Michael Marti

Date Deposited:

28 Jul 2021 10:06

Last Modified:

29 Sep 2021 01:33

Publisher DOI:

10.1093/bjs/znab101

PubMed ID:

33761533

Additional Information:

Gregor Jan Kocher is collaborator of COVIDSurg Collaborative, GlobalSurg Collaborative

BORIS DOI:

10.48350/157720

URI:

https://boris.unibe.ch/id/eprint/157720

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