SP9.15 Rates of COVID-19 infection and mortality following elective surgery at a tertiary NHS Trust in relation to operative caseload

Abstract

Abstract Aims Elective surgery globally has been halted by COVID-19 due to apparent significant mortality rates with changes in planned surgery pathways. This audit examines COVID-19 infection and mortality rates at key intervals throughout the UK COVID-19 pandemic in relation to operative elective caseload at an NHS Trust. Methods Prospective cohort of elective surgical patients at a tertiary NHS Trust between March 2020-March 2022, examining three time periods. Period 1: 1st UK Lockdown (April-July 2020). Period 2: 2nd-3rd UK Lockdowns (November 2020-March 2021). Period 3: Omicron wave (December 2021-February 2022). Post-operative PCR positive COVID-19 infection rates within 30-days, proportion fully “double-jabbed” vaccinated, 90-day mortality and any COVID-19 related deaths are reported. Audit registration 20-190C. Results Between March 2020-2022, of 50,247 operations, 518 (1.03%) developed COVID-19 infection of which 62 (11.97%) died giving an overall COVID-19 death rate of 0.12%. Between Periods 1 and 3, despite a 53% increase in operations per week (294 to 450) the proportion of COVID-19 infected patients remained similar (1.12% and 1.14%). Between Periods 2-3, despite an almost 6-fold increase in fully vaccinated patients (9.80% to 57.74%), the proportion of vaccinated COVID-19 positive patients increased (4.20% to 55.38%). However, the overall proportion of COVID-19 infections decreased (2.53% to 1.14%) as well as the mortality of those infected (15.97% to 9.23%). Conclusions Overall COVID-19 infection and mortality rates are low. These have been maintained despite increases in operative caseload, suggesting further sustained elective surgery can re-commence. This may relate to an increase in fully vaccinated patients undergoing surgery.