2023 update on timing of elective surgery and risk assessment after SARS-CoV-2 infection
The Association of Anaesthetist’s journal Anaesthesia has published updated guidance on the timing of elective surgery and risk assessment after SARS-CoV-2 infection.
The guidance is a multidisciplinary consensus statement on behalf of the Association of Anaesthetists, Federation of Surgical Specialty Associations, Royal College of Anaesthetists and Royal College of Surgeons of England.
The American Society of Anesthesiologists and the Anesthesia Patient Safety Foundation also support the recommendations.
The authors note that previous guidance for the timing of surgery following SARS-CoV-2 infection needed reassessment given widespread vaccination, less virulent variants, contemporary evidence and a need to increase access to safe surgery.
The guidance recommends that patients who develop symptoms of SARS-CoV-2 infection within seven weeks of planned surgery, including on the day of surgery, should be screened for SARS-CoV-2. Elective surgery should not usually be undertaken within two weeks of diagnosis of SARS-CoV-2 infection.
For patients who have recovered from SARS-CoV-2 infection and who are low-risk or having low-risk surgery, most elective surgery can proceed two weeks following a SARS-CoV-2 positive test. For patients who are not low-risk or having anything other than low-risk surgery between two and seven weeks following infection, an individual risk assessment must be performed.
The guidance notes that there is currently no evidence to support delaying surgery beyond seven weeks for patients who have fully recovered from or have had mild SARS-CoV-2 infection.
Dr Matt Davies, President of the Association of the Anaesthetists, said: “This comprehensive guidance produced from a multidisciplinary team updates the original guidance produced in the midst of the pandemic. This will mean less patients will have their surgery delayed due to SARS-COV-2 infection and result in less disruption for patients and for theatre lists (with on the day cancellations being reduced). This will be a vital part of the significant challenge the current rising surgical waiting list places on the overstretched National Health Service.”
Professor Kariem El-Boghdadly, co-author of the guidance, said: “As we navigate to a different phase of the pandemic, healthcare professionals and patients needed support with decision-making on timing of surgery following SARS-CoV-2 infection in light of new evidence. We therefore updated previous recommendations with the aim of facilitating safe surgery proceeding in a timely manner. Underpinning these recommendations are risk assessment and shared decision making, and we hope that timing of surgery is guided by these two key principles for the benefit of patients across the UK and globally.”