SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study
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URI: http://hdl.handle.net/10818/53942Visitar enlace: https://www.ncbi.nlm.nih.gov/p ...
ISSN: 13652168
DOI: 10.1093/bjs/znab101
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NIHR Global Health Research Unit on Global Surgery; Heritage Building, University of Birmingham; Mindelsohn WayFecha
2021Resumen
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.
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Ubicación
British Journal of Surgery 108, no. 9 (2021): 1056-1063
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