Project #33:
Post-operative outcomes and resource use in cancer surgery patients with perioperative SARS-CoV2.

Patients who need surgery for cancer must balance the risks of undergoing and not undergoing surgery. The decision to undergo surgery is complicated by other existing conditions and diseases that the patient has. For example, there is some evidence that patients with an indication of SARS-CoV-2 infection might be at greater risk of death shortly after surgery, compared with patients who did not have an indication of infection. This increased risk might persist up to 7 weeks after surgery, in some cases.

In light of the increased risk of death, NHS England and NHS Improvement issued guidance to delay non-urgent, non-emergency operations for three months. The findings of research studies around that time varied in their support of such delays. For example, one global study suggested that non-emergency surgeries should be delayed for more than 4 weeks, while another study suggested the increase in the risk of death related to a SARS-CoV-2 infection was very low and might not outweigh the risks of delaying. The conflicting evidence makes it difficult for hospitals to safely plan surgeries, especially because it is not clear why there is such a wide range of advice given.

Our study attempts to review the relationship between surgery timing and cancer patient outcomes after surgery in light of the NHS England and NHS Improvement guidance. In addition to patient outcomes - e.g. death and post-operative complications - we will study the effect of surgery timing and patients’ SARS-CoV-2 status on outcomes related to hospital planning (e.g. patients’ length of stay in hospital and readmissions after discharge).