Our modelling analysis suggests that ~750,000 operations may have already been postponed in NHS England due to COVID-19, which could increase to ~2.2 million by March 2021 as elective surgery is gradually reintroduced medrxiv.org/cgi/content/sh… (Pre-print. Not yet peer-reviewed).

We estimate that the financial cost of clearing the current backlog of postponed operations in NHS England is ~£1.3bn. This could increase to over ~£5bn by March 2021 as the reintroduction of elective surgery will be gradual. medrxiv.org/content/10.110… (Pre-print. Not peer-reviewed)

Patients with covid at ‘very high risk of death’ after surgery | Evening Standard Research from ⁦Tom Abbott⁩ ⁦Alex Fowler⁩ ⁦@rupert_pearse⁩ ⁦CCPMG⁩ ⁦Queen Mary University of London⁩ ⁦Standard News⁩ standard.co.uk/news/health/pa…

1/ Increasing numbers of patients aged 75 or older are undergoing surgery, but it is unclear whether these treatments are needed or whether they improve quality of life. academic.oup.com/bjs/article/10… Alex Fowler @rupert_pearse BJS

We are excited that @rupert_pearse will be presenting the results of PRISM Trial at #Anaesthesia2021 at 12.10 today. Find out about routine postoperative CPAP here. CCPMG Royal College of Anaesthetists

.@rupert_pearse explains in the prelude to PRISM Trial - there *may* be a @CochraneUK signal towards the use of CPAP in abdominal surgery #Anaesthesia2021

PRISM Trial recruited 4800 patients over 4 years from over 60 centres #Anaesthesia2021

PRISM Trial found no difference in the incidence of pneumonia, re-intubation or death within 30 days of surgery between patients randomised to CPAP or usual postoperative care. #Anaesthesia2021

For those that missed the talk at #Anaesthesia2021 you can see a pre-recorded video of @rupert_pearse presenting the results of PRISM Trial here: youtu.be/kYSHWmluwPc Or visit our website: prismtrial.org doi.org/10.1016/S2213-…

Interesting trial of CPAP vs usual care post-op for major surgery by @rupert_pearse’s team. No difference between the groups though. Important trial, especially as we might assume treatments like this work, they certainly make our numbers better. #Anaesthesia2021

#Anaesthesia2021 PRISM Trial fantastic trial. Really important trial type in my mind. Real world implementation results.

Published today in The Lancet Respiratory Medicine is the final report of PRISM Trial, an international multi-centre phase-3 randomised trial of routine postoperative CPAP to prevent pneumonia, re-intubation & death after major abdominal surgery sciencedirect.com/science/articl… @rupert_pearse William Harvey Research Institute

2/ We included 4793 patients aged over 50 years undergoing major open abdominal surgery from 70 hospitals across Italy, Spain, Norway, Sweden, South Africa & the UK between Feb 2016 & Nov 2019. PRISM Trial Bruce Biccard Ib Jammer cesar aldecoa CCPMG sciencedirect.com/science/articl…

3/ Patients were randomly assigned to receive either Continuous Positive Airway Pressure (CPAP) within 4hr after the end of surgery or usual postoperative care. PRISM Trial sciencedirect.com/science/articl…

4/ The primary outcome was a composite of pneumonia, endotracheal re-intubation or death within 30 days after randomisation. We undertook an intention to treat analysis according to published protocol minervamedica.it/en/journals/mi… PRISM Trial

5/ 8.1% of patients in the CPAP group met the primary outcome of pneumonia, re-intubation or death within 30 days after randomisation compared to 8.2% of patients in the usual care group (odds ratio 1.01, p=0.95). sciencedirect.com/science/articl… PRISM Trial

6/ We found no differences between CPAP and standard postoperative care for any of our pre-specified secondary outcomes. sciencedirect.com/science/articl… PRISM Trial

7/ The results of PRISM Trial do not support the routine use of postoperative CPAP to prevent pneumonia, re-intubation or death after major abdominal surgery. sciencedirect.com/science/articl… @rupert_pearse CCPMG William Harvey Research Institute Barts and The London, Queen Mary

8/ A big thank you to our international teams of investigators across Europe & South Africa and to our funders National Institute for Health and Care Research Barts Charity Association of Anaesthetists Intersurgical & Sapienza University Thank you! Ib Jammer Bruce Biccard cesar aldecoa Tamas Szakmany MBE PRISM Trial CCPMG

The final report of PRISM trial has been published by The Lancet Respiratory Medicine Here, @rupert_pearse gives a video summary youtu.be/kYSHWmluwPc Thread below: Tom Abbott gives a summary of the key results. Link to download paper: sciencedirect.com/science/articl…