Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Critical Care and Perioperative Medicine Research Group, William Harvey Research Institute, Queen Mary University of London, London, UK.
Br J Anaesth. 2024 Oct;133(4):768-775. doi: 10.1016/j.bja.2024.06.028. Epub 2024 Jul 31.
The average number of times a person will have surgery in their lifetime, and the amount of surgical healthcare resources they use, is unknown. Lifetime risk is a measure of the risk of an average person having a specific event within their lifetime. We report the lifetime risk of surgery and the change observed during the first year of the COVID-19 pandemic.
We conducted a population cohort study using hospital episode statistics to identify all patients undergoing surgery between January 1, 2016, and December 31, 2020, in England. We calculated age- and sex-specific incidence rates of surgery and combined these with routinely available population and mortality data from the Office for National Statistics. We computed the probability of requiring surgery stratified by 5-yr epochs (age 0-4 to ≥90 yr). Our primary analysis calculated lifetime risk for all surgery using the life table method. We assessed the impact of the COVID-19 pandemic, comparing a pre-pandemic and a pandemic period.
Between 2016 and 2020, 23 427 531 patients underwent surgery, of which 11 937 062 were first surgeries. The average denominator population for England was 55.9 million. The lifetime risk of first surgery was 60.2% (95% confidence interval 55.1-65.4%) for women and 59.1% (95% confidence interval 54.2-64.1%) for men. The COVID-19 pandemic decreased the lifetime risk of first surgery by 32.3% for women and by 31.7% for men. This estimated lifetime risk should only be applied to the English population.
This population epidemiological analysis suggests that approximately 60% of people in England will undergo surgery in their lifetime.
目前尚不清楚一个人一生中需要进行手术的平均次数，以及他们使用的外科医疗资源数量。终生风险是衡量一般人在其一生中发生特定事件的风险的一种指标。我们报告了手术的终生风险以及在 COVID-19 大流行的第一年观察到的变化。
我们使用医院病例统计数据进行了一项人群队列研究，以确定 2016 年 1 月 1 日至 2020 年 12 月 31 日期间在英格兰接受手术的所有患者。我们计算了按年龄和性别划分的手术发生率，并将这些发生率与英国国家统计局提供的常规人口和死亡率数据相结合。我们根据 5 年间隔（0-4 岁至≥90 岁）对手术需求概率进行分层计算。我们的主要分析使用寿命表法计算了所有手术的终生风险。我们评估了 COVID-19 大流行的影响，比较了大流行前和大流行期间的情况。
在 2016 年至 2020 年间，共有 2342.7531 万名患者接受了手术，其中 1193.7062 万名患者接受了首次手术。英格兰的平均分母人口为 5590 万人。女性首次手术的终生风险为 60.2%（95%置信区间为 55.1%-65.4%），男性为 59.1%（95%置信区间为 54.2%-64.1%）。COVID-19 大流行使女性首次手术的终生风险降低了 32.3%，男性降低了 31.7%。这种估计的终生风险仅适用于英格兰人口。
这项人群流行病学分析表明，英格兰约有 60%的人在其一生中需要接受手术。
