| dc.description.abstract | Objectives: To confirm the incidence of perioperative SARS-CoV-2 infection and associated
mortality after surgery.
Design and setting: Analysis of routine electronic health record data from National Health
Service (NHS) hospitals in England.
Methods: We extracted data from Hospital Episode Statistics in England describing adult
patients undergoing surgery between 1st January 2020 and 31st October 2020. The
exposure was SARS-CoV-2 infection defined by ICD-10 codes. The primary outcome
measure was 90-day in-hospital mortality. Data were analysed using multivariable logistic
regression adjusted for age, sex, Charlson co-morbidity index, index of multiple
deprivation, presence of cancer, surgical procedure type and admission acuity. Results are
presented as n (%) and odds ratios (OR) with 95% confidence intervals.
Results: We identified 1,972,153 patients undergoing surgery of whom 11,940 (0.6%) had
SARS-CoV-2. In total, 19,100 (1.0%) patients died in hospital. SARS-CoV-2 infection was
associated with a much greater risk of death (SARS-CoV-2: 2,618/11,940 [21.9%] vs No
SARS-CoV-2: 16,482/1,960,213 [0.8%]; OR: 5.8 [5.5 – 6.1]; p<0.001). Amongst patients
undergoing elective surgery 1,030/1,374,985 (0.1%) had SARS-CoV-2 of whom 83/1,030
(8.1%) died, compared with 1,092/1,373,955 (0.1%) patients without SARS-CoV-2 (OR: 29.0
[22.5 - 37.3]; p<0.001). Amongst patients undergoing emergency surgery 9,742/437,891
(2.2%) patients had SARS-CoV-2, of whom 2,466/9,742 (25.3%) died compared with
14,817/428,149 (3.5%) patients without SARS-CoV-2 (OR: 5.7 [5.4 – 6.0]; p<0.001).
Conclusions: The low incidence of SARS-CoV-2 infection in NHS surgical pathways suggests
current infection prevention and control policies are highly effective. However, the high
mortality amongst patients with SARS-CoV-2 suggests these precautions cannot be safely
relaxed. | en_US |
