Imperial College London
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Dr Jonathan M Clarke

Faculty of Natural Sciences, Department of Mathematics

Sir Henry Wellcome Postdoctoral Fellow
 
 
 
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Contact

 

j.clarke Website

 
 
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Location

 

St Marys Multiple BuildingsSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Beatty:2021:10.1097/SLA.0000000000005152,
author = {Beatty, JW and Clarke, JM and Sounderajah, V and Acharya, A and Rabinowicz, S and Martin, G and Warren, LR and Yalamanchili, S and Scott, AJ and Burgnon, E and Purkayastha, S and Markar, S and Kinross, JM and PANSURG-PREDICT, Collaborative},
doi = {10.1097/SLA.0000000000005152},
journal = {Annals of Surgery},
pages = {904--912},
title = {Impact of the COVID-19 pandemic on emergency adult surgical patients and surgical services: an international multi-center cohort study and department survey.},
url = {http://dx.doi.org/10.1097/SLA.0000000000005152},
volume = {274},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVES: The PREDICT study aimed to determine how the COVID-19 pandemic affected surgical services and surgical patients and to identify predictors of outcomes in this cohort. BACKGROUND: High mortality rates were reported for surgical patients with COVID-19 in the early stages of the pandemic. However, the indirect impact of the pandemic on this cohort is not understood, and risk predictors are yet to be identified. METHODS: PREDICT is an international longitudinal cohort study comprising surgical patients presenting to hospital between March and August 2020, conducted alongside a survey of staff redeployment and departmental restructuring. A subgroup analysis of 3176 adult emergency patients, recruited by 55 teams across 18 countries is presented. RESULTS: Among adult emergency surgical patients, all-cause in-hospital mortality (IHM) was 3 6%, compared to 15 5% for those with COVID-19. However, only 14 1% received a COVID-19 test on admission in March, increasing to 76 5% by July.Higher Clinical Frailty Scale scores (CFS >7 aOR 18 87), ASA grade above 2 (aOR 4 29), and COVID-19 infection (aOR 5 12) were independently associated with significantly increased IHM.The peak months of the first wave were independently associated with significantly higher IHM (March aOR 4 34; April aOR 4 25; May aOR 3 97), compared to non-peak months.During the study, UK operating theatre capacity decreased by a mean of 63 6% with a concomitant 27 3% reduction in surgical staffing. CONCLUSION: The first wave of the COVID-19 pandemic significantly impacted surgical patients, both directly through co-morbid infection and indirectly as shown by increasing mortality in peak months, irrespective of COVID-19 status.Higher CFS scores and ASA grades strongly predict outcomes in surgical patients and are an important risk assessment tool during the pandemic.
AU  - Beatty,JW
AU  - Clarke,JM
AU  - Sounderajah,V
AU  - Acharya,A
AU  - Rabinowicz,S
AU  - Martin,G
AU  - Warren,LR
AU  - Yalamanchili,S
AU  - Scott,AJ
AU  - Burgnon,E
AU  - Purkayastha,S
AU  - Markar,S
AU  - Kinross,JM
AU  - PANSURG-PREDICT,Collaborative
DO  - 10.1097/SLA.0000000000005152
EP  - 912
PY  - 2021///
SN  - 0003-4932
SP  - 904
TI  - Impact of the COVID-19 pandemic on emergency adult surgical patients and surgical services: an international multi-center cohort study and department survey.
T2  - Annals of Surgery
UR  - http://dx.doi.org/10.1097/SLA.0000000000005152
UR  - https://www.ncbi.nlm.nih.gov/pubmed/34402804
UR  - https://journals.lww.com/annalsofsurgery/Abstract/9000/Impact_of_the_COVID_19_pandemic_On_Emergency_Adult.93322.aspx
UR  - http://hdl.handle.net/10044/1/91327
VL  - 274
ER  -
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