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Comment
. 2021 Aug;45(8):2315-2324.
doi: 10.1007/s00268-021-06099-z. Epub 2021 Apr 20.

The PanSurg-PREDICT Study: Endocrine Surgery During the COVID-19 Pandemic

K Van Den Heede  1 , S Chidambaram  2 , J Winter Beatty  2 , N Chander  3 , S Markar  2 , N S Tolley  3   2 , F F Palazzo  3   2 , J K Kinross  2 , A N Di Marco  3   2 ; PanSurg Collaborative and the PREDICT-Endocrine Collaborative
Collaborators, Affiliations
Comment

The PanSurg-PREDICT Study: Endocrine Surgery During the COVID-19 Pandemic

K Van Den Heede et al. World J Surg. 2021 Aug.

Erratum in

Abstract

Background: In the midst of the COVID-19 pandemic, patients have continued to present with endocrine (surgical) pathology in an environment depleted of resources. This study investigated how the pandemic affected endocrine surgery practice.

Methods: PanSurg-PREDICT is an international, multicentre, prospective, observational cohort study of emergency and elective surgical patients in secondary/tertiary care during the pandemic. PREDICT-Endocrine collected endocrine-specific data alongside demographics, COVID-19 and outcome data from 11-3-2020 to 13-9-2020.

Results: A total of 380 endocrine surgery patients (19 centres, 12 countries) were analysed (224 thyroidectomies, 116 parathyroidectomies, 40 adrenalectomies). Ninety-seven percent were elective, and 63% needed surgery within 4 weeks. Eight percent were initially deferred but had surgery during the pandemic; less than 1% percent was deferred for more than 6 months. Decision-making was affected by capacity, COVID-19 status or the pandemic in 17%, 5% and 7% of cases. Indication was cancer/worrying lesion in 61% of thyroidectomies and 73% of adrenalectomies and calcium 2.80 mmol/l or greater in 50% of parathyroidectomies. COVID-19 status was unknown at presentation in 92% and remained unknown before surgery in 30%. Two-thirds were asked to self-isolate before surgery. There was one COVID-19-related ICU admission and no mortalities. Consultant-delivered care occurred in a majority (anaesthetist 96%, primary surgeon 76%). Post-operative vocal cord check was reported in only 14% of neck endocrine operations. Both of these observations are likely to reflect modification of practice due to the pandemic.

Conclusion: The COVID-19 pandemic has affected endocrine surgical decision-making, case mix and personnel delivering care. Significant variation was seen in COVID-19 risk mitigation measures. COVID-19-related complications were uncommon. This analysis demonstrates the safety of endocrine surgery during this pandemic.

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Figures

Fig. 1
Fig. 1
Overview of risk mitigation measure differences
See this image and copyright information in PMC

Comment on

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