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Cataract risk stratification and prioritisation protocol in the COVID-19 era
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dc.contributor.author | Cheng, Kelvin | |
dc.contributor.author | Anderson, Martin | |
dc.contributor.author | Velissaris, S. | |
dc.contributor.author | Moreton, Robert Berkeley Reynolds | |
dc.contributor.author | Al-Mansour, Ahmed | |
dc.contributor.author | Sanders, Roshini | |
dc.contributor.author | Sutherland, Shona | |
dc.contributor.author | Wilson, Peter | |
dc.contributor.author | Blaikie, Andrew | |
dc.date.accessioned | 2021-02-18T16:30:07Z | |
dc.date.available | 2021-02-18T16:30:07Z | |
dc.date.issued | 2021-02-17 | |
dc.identifier | 272825849 | |
dc.identifier | e3e2b1c4-11a9-44c6-acbe-ab813f4acc6b | |
dc.identifier | 85101034832 | |
dc.identifier | 000621056000002 | |
dc.identifier.citation | Cheng , K , Anderson , M , Velissaris , S , Moreton , R B R , Al-Mansour , A , Sanders , R , Sutherland , S , Wilson , P & Blaikie , A 2021 , ' Cataract risk stratification and prioritisation protocol in the COVID-19 era ' , BMC Health Services Research , vol. 21 , 153 . https://doi.org/10.1186/s12913-021-06165-1 | en |
dc.identifier.issn | 1472-6963 | |
dc.identifier.other | ORCID: /0000-0001-7913-6872/work/89178478 | |
dc.identifier.uri | https://hdl.handle.net/10023/21449 | |
dc.description.abstract | Background The COVID-19 pandemic halted non-emergency surgery across Scotland. Measures to mitigate the risks of transmitting COVID-19 are creating significant challenges to restarting all surgical services safely. We describe the development of a risk stratification tool to prioritise patients for cataract surgery taking account both specific risk factors for poor outcome from COVID-19 infection as well as surgical ‘need’. In addition we report the demographics and comorbidities of patients on our waiting list. Methods A prospective case review of electronic records was performed. A risk stratification tool was developed based on review of available literature on systemic risk factors for poor outcome from COVID-19 infection as well as a surgical ‘need’ score. Scores derived from the tool were used to generate 6 risk profile groups to allow prioritised allocation of surgery. Results There were 744 patients awaiting cataract surgery of which 66 (8.9 %) patients were ‘shielding’. One hundred and thirty-two (19.5 %) patients had no systemic comorbidities, 218 (32.1 %) patients had 1 relevant systemic comorbidity and 316 (46.5 %) patients had 2 or more comorbidities. Five hundred and ninety patients (88.7 %) did not have significant ocular comorbidities. Using the risk stratification tool, 171 (23 %) patients were allocated in the highest 3 priority stages. Given an aging cohort with associated increase in number of systemic comorbidities, the majority of patients were in the lower priority stages 4 to 6. Conclusions COVID-19 has created an urgent challenge to deal safely with cataract surgery waiting lists. This has driven the need for a prompt and pragmatic change to the way we assess risks and benefits of a previously regarded as low-risk intervention. This is further complicated by the majority of patients awaiting cataract surgery being elderly with comorbidities and at higher risk of mortality related to COVID-19. We present a pragmatic method of risk stratifying patients on waiting lists, blending an evidence-based objective assessment of risk and patient need combined with an element of shared decision-making. This has facilitated safe and successful restarting of our cataract service. | |
dc.format.extent | 9 | |
dc.format.extent | 1339911 | |
dc.language.iso | eng | |
dc.relation.ispartof | BMC Health Services Research | en |
dc.subject | COVID-19 | en |
dc.subject | RA0421 Public health. Hygiene. Preventive Medicine | en |
dc.subject | RD Surgery | en |
dc.subject | RE Ophthalmology | en |
dc.subject | 3rd-DAS | en |
dc.subject | SDG 3 - Good Health and Well-being | en |
dc.subject.lcc | RA0421 | en |
dc.subject.lcc | RD | en |
dc.subject.lcc | RE | en |
dc.title | Cataract risk stratification and prioritisation protocol in the COVID-19 era | en |
dc.type | Journal article | en |
dc.contributor.institution | University of St Andrews. Infection and Global Health Division | en |
dc.contributor.institution | University of St Andrews. School of Medicine | en |
dc.identifier.doi | 10.1186/s12913-021-06165-1 | |
dc.description.status | Peer reviewed | en |
dc.identifier.url | https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06165-1 | en |
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