The Risk of Postoperative Complications After Major Elective Surgery in Active or Resolved COVID-19 in the United States

被引：129

作者：

Deng, John Z. ^{[1
]}

Chan, Janine S. ^{[2
]}

Potter, Alexandra L. ^{[3
]}

Chen, Ya-Wen ^{[4
,5
]}

Sandhu, Harpal S. ^{[6
,7
]}

Panda, Nikhil ^{[4
,5
]}

Chang, David C. ^{[4
,5
]}

Yang, Chi-Fu Jeffrey ^{[5
,8
]}

机构：

[1] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA

[2] Univ Southern Calif, Keck Sch Med, Los Angeles, CA 90007 USA

[3] Univ Calif Berkeley, Berkeley, CA 94720 USA

[4] Massachusetts Gen Hosp, Dept Surg, Boston, MA 02114 USA

[5] Harvard Med Sch, Boston, MA 02115 USA

[6] Retina Northwest, Portland, OR USA

[7] Univ Louisville, Dept Bioengn, Louisville, KY 40292 USA

[8] Massachusetts Gen Hosp, Dept Surg, Div Thorac Surg, Boston, MA 02114 USA

来源：

ANNALS OF SURGERY | 2022年 / 275卷 / 02期

关键词：

COVID-19; operation; postoperative pulmonary complications; SARS-CoV-2; surgery; CLINICAL CHARACTERISTICS; PERIOPERATIVE MORBIDITY; MORTALITY; MULTICENTER;

D O I：

10.1097/SLA.0000000000005308

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Objective: To assess the association between the timing of surgery relative to the development of Covid-19 and the risks of postoperative complications. Summary Background Data: It is unknown whether patients who recovered from Covid-19 and then underwent a major elective operation have an increased risk of developing postoperative complications. Methods: The risk of postoperative complications for patients with Covid-19 undergoing 18 major types of elective operations in the Covid-19 Research Database was evaluated using multivariable logistic regression. Patients were grouped by time of surgery relative to SARS-CoV-2 infection; that is, surgery performed: (1) before January 1, 2020 ("pre-Covid-19"), (2) 0 to 4 weeks after SARS-CoV-2 infection ("peri-Covid-19"), (3) 4 to 8 weeks after infection ("early post-Covid-19"), and (4) >= 8 weeks after infection ("late post-Covid-19"). Results: Of the 5479 patients who met study criteria, patients with peri-Covid-19 had an elevated risk of developing postoperative pneumonia [adjusted odds ratio (aOR), 6.46; 95% confidence interval (CI): 4.06-10.27], respiratory failure (aOR, 3.36; 95% CI: 2.22-5.10), pulmonary embolism (aOR, 2.73; 95% CI: 1.35-5.53), and sepsis (aOR, 3.67; 95% CI: 2.18-6.16) when compared to pre-Covid-19 patients. Early post-Covid-19 patients had an increased risk of developing postoperative pneumonia when compared to pre-Covid-19 patients (aOR, 2.44; 95% CI: 1.20-4.96). Late post-Covid-19 patients did not have an increased risk of postoperative complications when compared to pre-Covid-19 patients. Conclusions: Major, elective surgery 0 to 4 weeks after SARS-CoV-2 infection is associated with an increased risk of postoperative complications. Surgery performed 4 to 8 weeks after SARS-CoV-2 infection is still associated with an increased risk of postoperative pneumonia, whereas surgery 8 weeks after Covid-19 diagnosis is not associated with increased complications.

引用

页码：242 / 246

页数：5

共 30 条

[1] COVID-19 Outbreak and Surgical Practice Unexpected Fatality in Perioperative Period [J].

Aminian, Ali ;

Safari, Saeed ;

Razeghian-Jahromi, Abdolali ;

Ghorbani, Mohammad ;

Delaney, Conor P. .

ANNALS OF SURGERY, 2020, 272 (01) :E27-E29

[2]

Anesthesia Patient Safety Foundation, Covid-19 and anesthesia FAQ

[3]

[Anonymous], COVID 19 DASHBOARD C

[4] Early postoperative outcomes among patients with delayed surgeries after preoperative positive test for SARS-CoV-2: A case-control study from a single institution [J].

Baiocchi, Glauco ;

Aguiar Jr, Samuel ;

Duprat, Joao P. ;

Coimbra, Felipe J. F. ;

Makdissi, Fabiana B. ;

Vartanian, Jose G. ;

Zequi, Stenio de C. ;

Gross, Jefferson L. ;

Nakagawa, Suely A. ;

Yazbek, Guilherme ;

Diniz, Thiago P. ;

Goncalves, Bruna T. ;

Zurstrassen, Charles E. ;

Campos, Heloisa G. do A. ;

Joaquim, Eduardo H. G. ;

Franca e Silva, Ivan A. ;

Kowalski, Luiz P. .

JOURNAL OF SURGICAL ONCOLOGY, 2021, 123 (04) :823-833

[5] Thrombosis in Hospitalized Patients With COVID-19 in a New York City Health System [J].

Bilaloglu, Seda ;

Aphinyanaphongs, Yin ;

Jones, Simon ;

Iturrate, Eduardo ;

Hochman, Judith ;

Berger, Jeffrey S. .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2020, 324 (08) :799-801

[6] Preparing previously COVID-19-positive patients for elective surgery: a framework for preoperative evaluation [J].

Bui, Naomi ;

Coetzer, Mareli ;

Schenning, Katie J. ;

O'Glasser, Avital Y. .

PERIOPERATIVE MEDICINE, 2021, 10 (01)

[7] Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: A living systematic review and meta-analysis [J].

Buitrago-Garcia, Diana ;

Egli-Gany, Dianne ;

Counotte, Michel J. ;

Hossmann, Stefanie ;

Imeri, Hira ;

Ipekci, Aziz Mert ;

Salanti, Georgia ;

Low, Nicola .

PLOS MEDICINE, 2020, 17 (09)

[8] Thoracic surgery outcomes for patients with Coronavirus Disease 2019 [J].

Chang, Stephanie H. ;

Chen, David ;

Paone, Darien ;

Geraci, Travis C. ;

Scheinerman, Joshua ;

Bizekis, Costas ;

Zervos, Michael ;

Cerfolio, Robert J. .

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2021, 162 (06) :1654-1664

[9] DVT incidence and risk factors in critically ill patients with COVID-19 [J].

Chen, Shujing ;

Zhang, Dingyu ;

Zheng, Tianqi ;

Yu, Yongfu ;

Jiang, Jinjun .

JOURNAL OF THROMBOSIS AND THROMBOLYSIS, 2021, 51 (01) :33-39

[10]

Collaborative C., 2021, Anesthesia, V76, p748 758

← 1 2 3 →