LITTLE ROCK — A new study shows that vaccinations for COVID-19 for those seeking elective surgery could be lifesaving.
Providing COVID-19 vaccines for patients awaiting elective surgery could save 58,687 lives worldwide over the next year, according to results of an international study in which the University of Arkansas for Medical Sciences (UAMS) participated.
The study findings, based on data gathered in 2020 by COVIDSurg Collaborative, an international network of surgeons, suggests that patients should receive a COVID-19 vaccine before surgery to reduce risk of postoperative death.
Patients who develop COVID-19 infection have a four to eight times higher risk of death in the 30 days following surgery.
For example, where patients aged 70 years and over undergoing cancer surgery would usually have a 2.8% mortality rate, this increases to 18.6% if they develop COVID-19 infection.
Based on the high risks that surgical patients face, scientists calculate that vaccination of surgical patients is more likely to prevent COVID-19 related deaths than vaccines given to the population at large; particularly among those 70 and older who are undergoing surgery for cancer. For example, where 1,840 people aged 70 and over in the general population need to be vaccinated to save one life over one year, this figure drops to only 351 in patients aged 70 years and over who are having cancer surgery.
“Surgical patients, particularly patients 70 years or older having cancer surgery, are a vulnerable group who are at increased risk of COVID-19 related death,” said Emmanouil (Manos) Giorgakis, M.D., a transplant surgeon at UAMS and an assistant professor in the College of Medicine’s Division of Transplant Surgery who led UAMS’ participation in the study. “Preoperative vaccination can significantly reduce postoperative mortality. Vaccination is also likely to decrease postoperative pulmonary complications, reducing intensive care use and overall health care costs.”
The COVIDSurg Collaborative international team of researchers, led by experts from the United Kingdom’s University of Birmingham, has published its findings in the BJS (incorporating the British Journal of Surgery and the European Journal of Surgery), after studying data for 141,582 patients from across 1,667 hospitals in 116 countries, including Australia, Brazil, China, India, the United Arab Emirates, the United Kingdom and the United States — creating the world’s largest-ever international study on surgery. The United States contributed data from 10,658 patients.
The study was undertaken in response to a need for evidence to guide surgical care during the pandemic, after a previous study showed that contracting the virus around the time of surgery can be catastrophic, increasing the risk of complications and death despite preoperative risk-reduction measures.
Another motivation was an urgent need for strategies to support the safe restart of backlogged surgeries.
The study concluded that as the global rollout of COVID-19 vaccines proceeds, patients needing elective surgery should be prioritized ahead of the general population. It also recommends that governments prioritize vaccination of surgical patients.