{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:46:47Z","timestamp":1791740807192,"version":"4.3.4"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001665","name":"Agence Nationale de la Recherche","doi-asserted-by":"publisher","award":["ANR\u201024\u2010CE10\u20107428"],"award-info":[{"award-number":["ANR\u201024\u2010CE10\u20107428"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001665","name":"Agence Nationale de la Recherche","doi-asserted-by":"publisher","award":["ANR\u201025\u2010PESN\u20100010"],"award-info":[{"award-number":["ANR\u201025\u2010PESN\u20100010"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>The ability to anticipate ICU beds mobilizable through elective surgical postponements during health system shocks remains poorly quantified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims and Objectives<\/jats:title>\n                    <jats:p>Using real\u2010world COVID\u201019 deprogramming data, we combined a classification of acceptable surgical deferral times with predictive models of expected surgical activity to estimate ICU capacity that can be generated in crisis scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We conducted a retrospective time\u2010series analysis of all surgical procedures performed from 2017 to 2021 in three AP\u2010HP university hospitals. Procedures were classified as non\u2010deferrable (red), deferrable &lt;\u20091 month (orange), or &gt;\u20091 month (green). Expected weekly surgical volumes for 2020\u20132021 without pandemic disruption were predicted using models trained on 2017\u20132018 and validated on 2019 (XGBoost, Holt\u2013Winters). Multivariable linear regression quantified the association between postponed procedures and ICU beds opened, enabling projection of capacity gains under different postponement scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 196,469 procedures, 59% were red, 20% orange, and 21% green. Surgical activity declined by 13% in 2020% and 8% in 2021, while ICU capacity increased by up to 85 and 46 beds, respectively. Reductions were mainly driven by postponement of green procedures (IRR 0.78 [0.75\u20130.80]). Only postponed green procedures were significantly associated with ICU bed expansion (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.75, 95% CI 0.53\u20130.97;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), accounting for 34.6% of ICU bed demand.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clinically acceptable postponement of low\u2010priority elective surgery contributes substantially to ICU surge capacity. Integrating prioritization and predictive modeling into preparedness strategies may support balanced, data\u2010driven responses to future healthcare system shocks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70665","type":"journal-article","created":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:31:25Z","timestamp":1791739885000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reallocating Surgical Activity to Expand Critical Care Capacity During the SARS\u2010CoV\u20102 Pandemic: A Descriptive and Analytical Study in a French University Hospital Network"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0187-8824","authenticated-orcid":false,"given":"Thomas","family":"Botrel","sequence":"first","affiliation":[{"name":"Sorbonne Universit\u00e9, GRC 29, Groupe de Recherche Clinique en Anesth\u00e9sie R\u00e9animation m\u00e9decine P\u00e9riop\u00e9ratoire, ARPE Paris France"},{"name":"Universit\u00e9 Paris\u2010Saclay, CentraleSup\u00e9lec, Laboratoire G\u00e9nie Industriel Gif\u2010sur\u2010Yvette France"},{"name":"Department of Anesthesiology and Critical Care APHP, H\u00f4pital La Piti\u00e9 Salp\u00eatri\u00e8re, DMU DREAM Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nesrine","family":"Moukebel","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris\u2010Saclay, CentraleSup\u00e9lec, Laboratoire G\u00e9nie Industriel Gif\u2010sur\u2010Yvette France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Legros","sequence":"additional","affiliation":[{"name":"SKEMA Business School, Universit\u00e9 C\u00f4te d'Azur Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrice","family":"Menegaux","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery Hepato\u2010Bilio\u2010Pancreatic Surgery and Liver Transplantation, Piti\u00e9\u2010Salp\u00eatri\u00e8re Hospital, Assistance Publique\u2014H\u00f4pitaux de Paris Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6849-1825","authenticated-orcid":false,"given":"Louis","family":"Puybasset","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, GRC 29, Groupe de Recherche Clinique en Anesth\u00e9sie R\u00e9animation m\u00e9decine P\u00e9riop\u00e9ratoire, ARPE Paris France"},{"name":"Department of Anesthesiology and Critical Care APHP, H\u00f4pital La Piti\u00e9 Salp\u00eatri\u00e8re, DMU DREAM Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Rufat","sequence":"additional","affiliation":[{"name":"Public Health Department Piti\u00e9\u2010Salp\u00eatri\u00e8re Hospital, 43\u201087 Bd de l'H\u00f4pital Paris 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