Timing of Surgery for Adults After COVID Guidance

In response to new evidence and one year after the publication of the original guidance, the updated 'SARS-CoV-2 infection, COVID-19, risk assessment and timing of elective adult surgery' multidisciplinary consensus statement has been published.

The statement is endorsed by the Centre for Perioperative Care, The Royal College of Anaesthetists, Royal College of Surgeons of England, Association of Anaesthetists and the Federation of Surgical Speciality Associations.

Summary 

Analysis of the new evidence indicates that there is still an evident risk to adult patients if they operated on within seven weeks of contracting COVID-19. However, for some high risk patients this risk needs to be quantified and balanced against the risk of delay.

The role of shared decision making is crucial to ensure patients personalised context is taken into account, patients are aware and understand the increased risks following infection, what decision is right for that patient and come to a collaborative decision on whether to wait/continue with the surgical intervention. For more information on shared decision making please see our patient and clinical pages. 

Preparation for surgery is key to reduce risk presenting from adverse postoperative outcomes and this is especially prevalent in those who have contracted COVID-19. Supporting patients to make positive lifestyle changes to prepare for surgery is the best defence to post-surgical and post-covid complications. Please see the RCoA's Fitter, Better, Sooner Resource for more information. 

Up to 15% of patients undergoing operations experience complications which are often preventable.

Risk quantification to evaluate a patients individualised risk is an important step when considering the timeline of surgery. Please see below the risk assessment communication tool that can be used when identifying and discussing the next steps for a patient. 

 

For Patients

The a summary of the guidance for patients has been developed and can be downloaded below. This explains the different levels of risk that patients will review in collaboration with their healthcare team through shared decision making. 

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