Association Between Preoperative COVID-19 Infection and Postoperative Outcomes in Patients with Obstructive Sleep Apnea Undergoing Metabolic Surgery: A Retrospective Analysis.
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引用次数: 0
Abstract
Background: Obstructive sleep apnea (OSA) is highly prevalent in patients undergoing metabolic surgery and can complicate recovery. While OSA and COVID-19 share common pathophysiological mechanisms involving systemic inflammation and respiratory dysfunction, their combined impact on surgical outcomes remains poorly understood.
Methods: Using TriNetX data from June 2022 to December 2024, we retrospectively analyzed adult patients with OSA undergoing metabolic surgery. Patients were divided into two groups: those with COVID-19 infection within 4 weeks before surgery and controls without infection in the preceding 8 weeks. After propensity score matching, 8,733 pairs were analyzed. The primary outcomes included postoperative pneumonia and respiratory failure within 30 days. The secondary outcomes included acute kidney injury (AKI), intensive care unit (ICU) admission, mortality, surgical site infection (SSI), emergency department (ED) visit, and deep vein thrombosis (DVT).
Results: No significant differences were found between the COVID-19 and control groups in postoperative pneumonia (0.28% vs. 0.32%, p = 0.5785) or respiratory failure (0.30% vs. 0.38%, p = 0.3613). Secondary outcomes, including the incidence of AKI, ICU admission, mortality, SSI, ED visit, and DVT, showed no significant differences. Chronic obstructive pulmonary disease (COPD) emerged as the strongest risk factor for both pneumonia (odds ratio 6.06, p = 0.002) and respiratory failure (odds ratio 4.22, p = 0.013).
Conclusion: Recent preoperative COVID-19 infection did not significantly impact postoperative outcomes in patients with OSA undergoing metabolic surgery. However, the presence of COPD substantially increases the risk of respiratory complications, suggesting the need for additional preoperative optimization in these patients.
期刊介绍:
Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions.
Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.