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Timing of elective surgery and risk assessment after SARS‐CoV‐2 infection: an update: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, Centre for Perioperative Care, Federation of Surgical Specialty Associations, Royal College of Anaesthetists, Royal College of Surgeons of England

The impact of vaccination and new SARS‐CoV‐2 variants on peri‐operative outcomes is unclear. We aimed to update previously published consensus recommendations on timing of elective surgery after SARS‐CoV‐2 infection to assist policymakers, administrative staff, clinicians and patients. The guidance...

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Autores principales: El‐Boghdadly, K., Cook, T. M., Goodacre, T., Kua, J., Denmark, S., McNally, S., Mercer, N., Moonesinghe, S. R., Summerton, D. J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9111236/
https://www.ncbi.nlm.nih.gov/pubmed/35194788
http://dx.doi.org/10.1111/anae.15699
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author El‐Boghdadly, K.
Cook, T. M.
Goodacre, T.
Kua, J.
Denmark, S.
McNally, S.
Mercer, N.
Moonesinghe, S. R.
Summerton, D. J.
author_facet El‐Boghdadly, K.
Cook, T. M.
Goodacre, T.
Kua, J.
Denmark, S.
McNally, S.
Mercer, N.
Moonesinghe, S. R.
Summerton, D. J.
author_sort El‐Boghdadly, K.
collection PubMed
description The impact of vaccination and new SARS‐CoV‐2 variants on peri‐operative outcomes is unclear. We aimed to update previously published consensus recommendations on timing of elective surgery after SARS‐CoV‐2 infection to assist policymakers, administrative staff, clinicians and patients. The guidance remains that patients should avoid elective surgery within 7 weeks of infection, unless the benefits of doing so exceed the risk of waiting. We recommend individualised multidisciplinary risk assessment for patients requiring elective surgery within 7 weeks of SARS‐CoV‐2 infection. This should include baseline mortality risk calculation and assessment of risk modifiers (patient factors; SARS‐CoV‐2 infection; surgical factors). Asymptomatic SARS‐CoV‐2 infection with previous variants increased peri‐operative mortality risk three‐fold throughout the 6 weeks after infection, and assumptions that asymptomatic or mildly symptomatic omicron SARS‐CoV‐2 infection does not add risk are currently unfounded. Patients with persistent symptoms and those with moderate‐to‐severe COVID‐19 may require a longer delay than 7 weeks. Elective surgery should not take place within 10 days of diagnosis of SARS‐CoV‐2 infection, predominantly because the patient may be infectious, which is a risk to surgical pathways, staff and other patients. We now emphasise that timing of surgery should include the assessment of baseline and increased risk, optimising vaccination and functional status, and shared decision‐making. While these recommendations focus on the omicron variant and current evidence, the principles may also be of relevance to future variants. As further data emerge, these recommendations may be revised.
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spelling pubmed-91112362022-05-17 Timing of elective surgery and risk assessment after SARS‐CoV‐2 infection: an update: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, Centre for Perioperative Care, Federation of Surgical Specialty Associations, Royal College of Anaesthetists, Royal College of Surgeons of England El‐Boghdadly, K. Cook, T. M. Goodacre, T. Kua, J. Denmark, S. McNally, S. Mercer, N. Moonesinghe, S. R. Summerton, D. J. Anaesthesia Guidelines The impact of vaccination and new SARS‐CoV‐2 variants on peri‐operative outcomes is unclear. We aimed to update previously published consensus recommendations on timing of elective surgery after SARS‐CoV‐2 infection to assist policymakers, administrative staff, clinicians and patients. The guidance remains that patients should avoid elective surgery within 7 weeks of infection, unless the benefits of doing so exceed the risk of waiting. We recommend individualised multidisciplinary risk assessment for patients requiring elective surgery within 7 weeks of SARS‐CoV‐2 infection. This should include baseline mortality risk calculation and assessment of risk modifiers (patient factors; SARS‐CoV‐2 infection; surgical factors). Asymptomatic SARS‐CoV‐2 infection with previous variants increased peri‐operative mortality risk three‐fold throughout the 6 weeks after infection, and assumptions that asymptomatic or mildly symptomatic omicron SARS‐CoV‐2 infection does not add risk are currently unfounded. Patients with persistent symptoms and those with moderate‐to‐severe COVID‐19 may require a longer delay than 7 weeks. Elective surgery should not take place within 10 days of diagnosis of SARS‐CoV‐2 infection, predominantly because the patient may be infectious, which is a risk to surgical pathways, staff and other patients. We now emphasise that timing of surgery should include the assessment of baseline and increased risk, optimising vaccination and functional status, and shared decision‐making. While these recommendations focus on the omicron variant and current evidence, the principles may also be of relevance to future variants. As further data emerge, these recommendations may be revised. John Wiley and Sons Inc. 2022-02-22 2022-05 /pmc/articles/PMC9111236/ /pubmed/35194788 http://dx.doi.org/10.1111/anae.15699 Text en © 2022 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Guidelines
El‐Boghdadly, K.
Cook, T. M.
Goodacre, T.
Kua, J.
Denmark, S.
McNally, S.
Mercer, N.
Moonesinghe, S. R.
Summerton, D. J.
Timing of elective surgery and risk assessment after SARS‐CoV‐2 infection: an update: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, Centre for Perioperative Care, Federation of Surgical Specialty Associations, Royal College of Anaesthetists, Royal College of Surgeons of England
title Timing of elective surgery and risk assessment after SARS‐CoV‐2 infection: an update: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, Centre for Perioperative Care, Federation of Surgical Specialty Associations, Royal College of Anaesthetists, Royal College of Surgeons of England
title_full Timing of elective surgery and risk assessment after SARS‐CoV‐2 infection: an update: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, Centre for Perioperative Care, Federation of Surgical Specialty Associations, Royal College of Anaesthetists, Royal College of Surgeons of England
title_fullStr Timing of elective surgery and risk assessment after SARS‐CoV‐2 infection: an update: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, Centre for Perioperative Care, Federation of Surgical Specialty Associations, Royal College of Anaesthetists, Royal College of Surgeons of England
title_full_unstemmed Timing of elective surgery and risk assessment after SARS‐CoV‐2 infection: an update: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, Centre for Perioperative Care, Federation of Surgical Specialty Associations, Royal College of Anaesthetists, Royal College of Surgeons of England
title_short Timing of elective surgery and risk assessment after SARS‐CoV‐2 infection: an update: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, Centre for Perioperative Care, Federation of Surgical Specialty Associations, Royal College of Anaesthetists, Royal College of Surgeons of England
title_sort timing of elective surgery and risk assessment after sars‐cov‐2 infection: an update: a multidisciplinary consensus statement on behalf of the association of anaesthetists, centre for perioperative care, federation of surgical specialty associations, royal college of anaesthetists, royal college of surgeons of england
topic Guidelines
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9111236/
https://www.ncbi.nlm.nih.gov/pubmed/35194788
http://dx.doi.org/10.1111/anae.15699
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