International surgical guidance for COVID-19: Validation using an international Delphi process - Cross-sectional study

Aj, Beamish; Brown, C.; Abdelrahman, Tarig; E, Ryan Harper; Rl, Harries; Egan, Richard

doi:10.1016/j.ijsu.2020.06.015

Cited by 8 publications

(6 citation statements)

References 7 publications

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“…During the early phases of the COVID‐19 pandemic there was uncertainty about the impact of perioperative SARS‐CoV‐2 on surgical patients and a growing scarcity of intensive care capacity [1,2]. Guidelines emerged which recommended changing anastomotic practice in favour of forming a defunctioning stoma or end stoma in patients who would have previously only had an anastomosis [3–6]. The first anticipated benefit was to diminish the severity and volume of postoperative anastomotic leaks during a time when the impact of the novel coronavirus was unknown [7].…”

Section: Introductionmentioning

confidence: 99%

Outcomes from elective colorectal cancer surgery during the SARS‐CoV‐2 pandemic

Collaborative

2020

Colorectal Disease

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Aim This study aimed to describe the change in surgical practice and the impact of SARS‐CoV‐2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS‐CoV‐2 pandemic. Method This was an international cohort study of patients undergoing elective resection of colon or rectal cancer without preoperative suspicion of SARS‐CoV‐2. Centres entered data from their first recorded case of COVID‐19 until 19 April 2020. The primary outcome was 30‐day mortality. Secondary outcomes included anastomotic leak, postoperative SARS‐CoV‐2 and a comparison with prepandemic European Society of Coloproctology cohort data. Results From 2073 patients in 40 countries, 1.3% (27/2073) had a defunctioning stoma and 3.0% (63/2073) had an end stoma instead of an anastomosis only. Thirty‐day mortality was 1.8% (38/2073), the incidence of postoperative SARS‐CoV‐2 was 3.8% (78/2073) and the anastomotic leak rate was 4.9% (86/1738). Mortality was lowest in patients without a leak or SARS‐CoV‐2 (14/1601, 0.9%) and highest in patients with both a leak and SARS‐CoV‐2 (5/13, 38.5%). Mortality was independently associated with anastomotic leak (adjusted odds ratio 6.01, 95% confidence interval 2.58–14.06), postoperative SARS‐CoV‐2 (16.90, 7.86–36.38), male sex (2.46, 1.01–5.93), age >70 years (2.87, 1.32–6.20) and advanced cancer stage (3.43, 1.16–10.21). Compared with prepandemic data, there were fewer anastomotic leaks (4.9% versus 7.7%) and an overall shorter length of stay (6 versus 7 days) but higher mortality (1.7% versus 1.1%). Conclusion Surgeons need to further mitigate against both SARS‐CoV‐2 and anastomotic leak when offering surgery during current and future COVID‐19 waves based on patient, operative and organizational risks.

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Section: Introductionmentioning

confidence: 99%

Outcomes from elective colorectal cancer surgery during the SARS‐CoV‐2 pandemic

Collaborative

2020

Colorectal Disease

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“…Examples of the application of the Delphi method to medical research include research on colorectal and breast cancer, (23) guidance in emergency nursing practice, (24) international surgical guidance for COVID-19, (25) core criteria set for health, (26) vulnerability of European pregnant women threatened by health risk factors such as chronic medical conditions, underlying diseases, smoking, alcohol, and so forth, (27) and the eHealthResp online course for pharmacists and physicians. (28)…”

Section: Delphi Methodsmentioning

confidence: 99%

Evaluation of Intensified Colorectal Cancer Treatment Using Model Based on Delphi Method, Fuzzy Logic, and Analytical Hierarchy Process (DFAHP)

Wu¹,

Ke²,

Meen³

2021

Sensors and Materials

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Colorectal cancer is one of the major fatal diseases in Taiwan, and the age of patients is decreasing yearly. As the early symptoms of malignant intestinal swelling are not obvious, most patients are not diagnosed with colorectal cancer until they are in a serious condition, and early diagnosis of colorectal cancer is a major challenge. In addition to genetic factors, colorectal cancer is caused by stress and poor dietary habits. To improve the effectiveness of treatment, we propose a model for multi-attribute decision-making based on medical data by combining the Delphi method, fuzzy logic theory, and the analytical hierarchy process. In the hierarchical structure, key risk factors and their values are proposed using fuzzy logic theory. The model suggests the importance of the medical team, medical equipment, post-operative care, and other factors for treating colorectal cancer effectively. Treatment and appropriate care must be integrated in the overall medical process to improve the effectiveness of colorectal cancer treatment.

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“…The mix-up occurred when an elevator company drained hydraulic fluid into empty detergent barrels and the detergent supplier mistakenly redistributed them. The COVID-19 pandemic has emphasised the importance of decreasing instrument contamination risks 9 as well as a general sense of urgency that may impose the risk of jumping to solutions too quickly. It is important to note that these latent safety threats have been there all along, but we are just noticing them more now than before because some of them are no longer latent.…”

Section: Understanding What Keeps Our Systems Safementioning

confidence: 99%

Unravelling the magic of latent safety threats

David¹

2020

BMJ Qual Saf

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International surgical guidance for COVID-19: Validation using an international Delphi process - Cross-sectional study

Cited by 8 publications

References 7 publications

Outcomes from elective colorectal cancer surgery during the SARS‐CoV‐2 pandemic

Outcomes from elective colorectal cancer surgery during the SARS‐CoV‐2 pandemic

Evaluation of Intensified Colorectal Cancer Treatment Using Model Based on Delphi Method, Fuzzy Logic, and Analytical Hierarchy Process (DFAHP)

Unravelling the magic of latent safety threats

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