Postoperative Outcomes in Surgical Coronavirus Disease 2019 Patients: A Retrospective Cohort Study.

IF 1.6 4区 医学 Q2 NURSING
Harihar V Hegde, Aswathy Chackochan, Raiya S Al Bahri, Ramlaa Malallah Abdullah, Manisha Paul, Suman Subbaraya Kandachar, Sanjeev Gopalakrishnan Nair, Anjalika S Weerasinghe, Jayamohan Kulikadavunkal, Umesh Chandra Mohnani
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Abstract

Purpose: Patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) who require surgical procedures are likely to experience higher postoperative mortality and morbidity. Our objective was to evaluate the perioperative course of patients infected with SARS-COV-2 undergoing surgical procedures. The purpose of this study was to describe the characteristics, outcomes, and the effect of the presence of symptoms.

Design: Retrospective cohort.

Methods: We analyzed the records of patients with SARS-CoV-2 infection who underwent surgical procedures from March 2020 to March 2021. Patients with ongoing infection at the time of surgery and those who had recently recovered were included. The primary outcome measure was 30-day in-hospital mortality after surgery. Secondary outcomes were intensive care unit (ICU) admission, length of stay in ICU, postoperative length of stay, and complications.

Findings: Data from 102 patients were analyzed. Twenty-four patients (23.5%) died postoperatively in the hospital within 30 days. Forty-four patients required ICU admission (average stay 13 days). The median postoperative length of stay was 8 days (interquartile range, 3.75 to 19.25 days). Pulmonary, thromboembolic, and surgical complications were noted in 29 (28.4%), 14 (13.7%), and 18 (17.6%), respectively. Patients aged 41 to 60 years experienced higher rates of pulmonary and thromboembolic complications. Comparison of asymptomatic versus symptomatic patients revealed significantly higher 30-day in-hospital mortality (9 [15%] vs 15 [35.7%], P = .019), ICU admission (17 [28.3%] vs 27 [64.3%], P < .001), length of stay in ICU (3 [2 to 11.5] vs 18 [7 to 27], P = .001), postoperative length of stay (6 [3 to 10.75] vs 12 [5 to 25.25], P = .016) and pulmonary complication rates (11 [18.3%] vs 18 [42.9%], P = .008) in the symptomatic patients.

Conclusions: Symptomatic SARS-COV-2 patients undergoing surgical procedures experience significantly higher 30-day in-hospital mortality, ICU admission, longer ICU and hospital stay, and pulmonary complications.

2019 年外科冠状病毒病患者的术后效果:回顾性队列研究
目的:感染严重急性呼吸系统综合征冠状病毒-2(SARS-COV-2)并需要进行外科手术的患者术后死亡率和发病率可能较高。我们的目的是评估接受外科手术的 SARS-COV-2 感染者的围手术期情况。本研究的目的是描述患者的特征、预后以及出现症状的影响:设计:回顾性队列研究:我们分析了 2020 年 3 月至 2021 年 3 月期间接受外科手术的 SARS-CoV-2 感染患者的记录。包括手术时感染仍在持续的患者和近期康复的患者。主要结果是手术后 30 天的院内死亡率。次要结果是入住重症监护室(ICU)、在重症监护室的住院时间、术后住院时间和并发症:对 102 名患者的数据进行了分析。24名患者(23.5%)术后30天内在医院死亡。44名患者需要入住重症监护室(平均住院13天)。术后住院时间中位数为 8 天(四分位数间距为 3.75 到 19.25 天)。出现肺部、血栓栓塞和手术并发症的患者分别为 29 人(28.4%)、14 人(13.7%)和 18 人(17.6%)。41至60岁的患者出现肺部和血栓栓塞并发症的比例较高。无症状患者与有症状患者的比较显示,无症状患者的 30 天院内死亡率(9 [15%] vs 15 [35.7%],P = .019)和入住重症监护室的比例(17 [28.3%] vs 27 [64.3%],P = .019)明显更高:接受外科手术治疗的无症状 SARS-COV-2 患者的 30 天院内死亡率、入住重症监护室、重症监护室和住院时间以及肺部并发症均明显增加。
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来源期刊
CiteScore
2.20
自引率
17.60%
发文量
279
审稿时长
90 days
期刊介绍: The Journal of PeriAnesthesia Nursing provides original, peer-reviewed research for a primary audience that includes nurses in perianesthesia settings, including ambulatory surgery, preadmission testing, postanesthesia care (Phases I and II), extended observation, and pain management. The Journal provides a forum for sharing professional knowledge and experience relating to management, ethics, legislation, research, and other aspects of perianesthesia nursing.
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