TY - JOUR
T1 - SARS-CoV-2 vaccination modelling for safe surgery to save lives
T2 - data from an international prospective cohort study
AU - COVIDSurg Collaborative, GlobalSurg Collaborative
AU - Study group members AMC, null
AU - Bakx, Roel
AU - Besselink, Marc G. H.
AU - Lemmers, Daan H. L.
AU - Roelofs, Anne
AU - van Amstel, Paul
AU - van Helsdingen, Claire P. M.
N1 - Netherlands: Eva Berkeveld, Frank Bloemers, Alexander Borgstein, Suzanne Gisbertz, Sarah Mikdad, Mark van Berge Henegouwen (Amsterdam UMC VUmc, Amsterdam); Roel Bakx, Marc Besselink, Daniel HL Lemmers, Anne-Jasmin Roelofs, Paul van Amstel, Claire van Helsdingen (Amsterdam UMC, University of Amsterdam, Amsterdam); Ludi Smeele (Antoni van Leeuwenhoek ziekenhuis, Amsterdam); Niels Harlaar, Frederik Jonker, Sjirk van der Burg, Justin Y. van Oostendorp (Rode Kruis Ziekenhuis, Beverwijk); Saranda Ombashi, Tim van der Voort, Martijn van Geldorp (Amphia, Breda); Lisanne Posma-Bouman (Slingeland Ziekenhuis, Doetinchem); Hans Donald de Boer, Annette Olieman, Henriette Smid-Nanninga (Martini General Hospital Groningen, Groningen); Jean-Paul P.M. De Vries, Rianne Hogenbirk, Schelto Kruijff, Milou Noltes, Pieter Steinkamp (University Medical Center Groningen, Groningen); Tyche Derksen, Josephine Franken, Steven Oosterling (Spaarne Gasthuis, Haarlem); Peter Nolte, Jelle van der List (Spaarne Gasthuis, Hoofddorp); Ian Alwayn, Okker Bijlstra, Andries Braat, Ruth Bulder, Michèle de Kok, Robin Faber, Ben Goudsmit, Jaap Hamming, Sven Mieog, Alexander Vahrmeijer, Fenna E.M. van de Leemkolk, Joost van der Vorst, Jan van Schaik, Merel Verhagen (Leiden University Medical Center, Leiden); Kim Albers, Larsa Gawria, Harry Van Goor, Michiel Warle (Radboud Universitair Medisch Centrum, Nijmegen); Tessa M. van Ginhoven, Charlotte Viëtor (Erasmus MC Cancer Institute, Rotterdam); Evert-Jan Boerma, Lara Lallitsch, Donald Schweitzer (Zuyderland Medical Centre, Sittard/Heerlen); Wouter Leclercq, Julie Sijmons, Peter-Jan Vancoillie (Máxima Medical Center, Veldhoven); Joop Konsten, Maarten van Heinsbergen (VieCuri Medisch Centrum, Venlo); Nicole Dekker, Frank den Boer (Zaans Medisch Centrum, Zaandam).
PY - 2021/9/27
Y1 - 2021/9/27
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85117739874&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/bjs/znab101
DO - https://doi.org/10.1093/bjs/znab101
M3 - Article
C2 - 33761533
SN - 0007-1323
VL - 108
SP - 1056
EP - 1063
JO - The British journal of surgery
JF - The British journal of surgery
IS - 9
ER -