Outcomes and Their State-level Variation in Patients Undergoing Surgery With Perioperative SARS-CoV-2 Infection in the USA. A Prospective Multicenter Study
Articolo
Data di Pubblicazione:
2022
Citazione:
Outcomes and Their State-level Variation in Patients Undergoing Surgery With Perioperative SARS-CoV-2 Infection in the USA. A Prospective Multicenter Study / Osaid, A., Ander Dorken, G., Anthony, G., Kerry, B., Mohamad El, M., Apostolos, G., Leon, N., Brittany, B., Hassan, M., Robert, D.S., Lydia, R.M., Charu, P., George, C.V., Dmitri, N., Aneel, B., Haytham M, A.K., Kwabena, S., Leah, A., Daoud, C., Brett, E.D., et al.. - In: ANNALS OF SURGERY. - ISSN 0003-4932. - 275:2(2022), pp. 247-251. [10.1097/SLA.0000000000005310]
Abstract:
Objective: To report the 30-day outcomes of patients with perioperative SARS-CoV-2 infection undergoing surgery in the USA.
Background: Uncertainty regarding the postoperative risks of patients with SARS-CoV-2 exists.
Methods: As part of the COVIDSurg multicenter study, all patients aged ≥17 years undergoing surgery between January 1 and June 30, 2020 with perioperative SARS-CoV-2 infection in 70 hospitals across 27 states were included. The primary outcomes were 30-day mortality and pulmonary complications. Multivariable analyses (adjusting for demographics, comorbidities, and procedure characteristics) were performed to identify predictors of mortality.
Results: A total of 1581 patients were included; more than half of them were males (n = 822, 52.0%) and older than 50 years (n = 835, 52.8%). Most procedures (n = 1261, 79.8%) were emergent, and laparotomies (n = 538, 34.1%). The mortality and pulmonary complication rates were 11.0 and 39.5%, respectively. Independent predictors of mortality included age ≥70 years (odds ratio 2.46, 95% confidence interval [1.65-3.69]), male sex (2.26 [1.53-3.35]), ASA grades 3-5 (3.08 [1.60-5.95]), emergent surgery (2.44 [1.31-4.54]), malignancy (2.97 [1.58-5.57]), respiratory comorbidities (2.08 [1.30-3.32]), and higher Revised Cardiac Risk Index (1.20 [1.02-1.41]). While statewide elective cancelation orders were not associated with a lower mortality, a sub-analysis showed it to be associated with lower mortality in those who underwent elective surgery (0.14 [0.03-0.61]).
Conclusions: Patients with perioperative SARS-CoV-2 infection have a significantly high risk for postoperative complications, especially elderly males. Postponing elective surgery and adopting non-operative management, when reasonable, should be considered in the USA during the pandemic peaks.
Background: Uncertainty regarding the postoperative risks of patients with SARS-CoV-2 exists.
Methods: As part of the COVIDSurg multicenter study, all patients aged ≥17 years undergoing surgery between January 1 and June 30, 2020 with perioperative SARS-CoV-2 infection in 70 hospitals across 27 states were included. The primary outcomes were 30-day mortality and pulmonary complications. Multivariable analyses (adjusting for demographics, comorbidities, and procedure characteristics) were performed to identify predictors of mortality.
Results: A total of 1581 patients were included; more than half of them were males (n = 822, 52.0%) and older than 50 years (n = 835, 52.8%). Most procedures (n = 1261, 79.8%) were emergent, and laparotomies (n = 538, 34.1%). The mortality and pulmonary complication rates were 11.0 and 39.5%, respectively. Independent predictors of mortality included age ≥70 years (odds ratio 2.46, 95% confidence interval [1.65-3.69]), male sex (2.26 [1.53-3.35]), ASA grades 3-5 (3.08 [1.60-5.95]), emergent surgery (2.44 [1.31-4.54]), malignancy (2.97 [1.58-5.57]), respiratory comorbidities (2.08 [1.30-3.32]), and higher Revised Cardiac Risk Index (1.20 [1.02-1.41]). While statewide elective cancelation orders were not associated with a lower mortality, a sub-analysis showed it to be associated with lower mortality in those who underwent elective surgery (0.14 [0.03-0.61]).
Conclusions: Patients with perioperative SARS-CoV-2 infection have a significantly high risk for postoperative complications, especially elderly males. Postponing elective surgery and adopting non-operative management, when reasonable, should be considered in the USA during the pandemic peaks.
Tipologia CRIS:
1.1 Articolo in rivista
Keywords:
COVID-19; COVIDSurg; elective surgery; emergency surgery; mortality; pulmonary complications
Elenco autori:
Osaid, Alser; Ander Dorken, Gallastegi; Anthony, Gebran; Kerry, Breen; Mohamad El, Moheb; Apostolos, Gaitanidis; Leon, Naar; Brittany, Bankhead-Kendall; Hassan, Mashbari; Robert, D Sinyard; Lydia, R Maurer; Charu, Paranjape; George, C Velmahos; Dmitri, Nepogodiev; Aneel, Bhangu; Haytham M, A Kaafarani; Kwabena, Siaw-Acheampong; Leah, Argus; Daoud, Chaudhry; Brett, E Dawson; James, C Glasbey; Rohan, R Gujjuri; Conor, S Jones; Sivesh, K Kamarajah; Chetan, Khatri; James, M Keatley; Samuel, Lawday; Elizabeth, Li; Harvinder, Mann; Ella, J Marson; Kenneth, A Mclean; Maria, Picciochi; Elliott, H Taylor; Abhinav, Tiwari; Joana F, F Simoes; Isobel, M Trout; Mary, L Venn; Richard J, W Wilkin; Aneel, Bhangu; Dmitri, Nepogodiev; Irida, Dajti; Arben, Gjata; Oussama, Kacimi; Luis, Boccalatte; Maria Marta, Modolo; Daniel, Cox; Peter, Pockney; Philip, Townend; Felix, Aigner; Irmgard, Kronberger; Ahmed, Elgun; Amer, Alderazi; Kamral, Hossain; Greg, Padmore; Gabrielle, Vanramshorst; Ismail, Lawani; Duane, Wedderburn; Sonam, Dargay; Israël, Feraudy; Cerovac, Anis; Samir, Delibegovic; Alemayehu Ginbo, Bedada; Gustavo, Ataide; Glauco, Baiocchi; Igor, Buarque; Muhammad, Gohar; Mihail, Slavchev; Jean Marie Vianney, Butoyi; Chukwuemeka, Nwegbu; Arnav, Agarwal; Amanpreet, Brar; Janet, Martin; Maria Marta, Modolo; Maricarmen, Olivos; Dong-Lin, Ren; Wenhui, Lou; Jose, Calvache; Carlos Jose Perez, Rivera; Ana Danic, Hadzibegovic; Tomislav, Kopjar; Jakov, Mihanovic; Pablo, Avilés; Nikolaos, Gouvas; Jaroslav, Klat; René, Novysedlak; Nicolas, Amisi; Peter, Christensen; Alaa, El-Hussuna; Sylvia, Batista; Eddy, Lincango; Sameh, H Emile; Danilo Alfonso Arévalo, Sandoval; Mengistu Gebreyohanes, Mengesha; Samuel, Hailu; Hailu, Tamiru; Joonas, Kauppila; Johanna, Laukkarinen; Alexis, Arnaud; Roumanatou Bankole, Sapin; Kebba, Marenah; Zaza, Demetrashvili; Andreas, A Schnitzbauer; Magdalena, Gruendl; Markus, Albertsmeiers; Hans, Lederhuber; Markus, Loffler; Bernard Ofori, Appiah; Daniel, Acquah; Stephen, Tabiri; Symeon, Metallidis; Georgios, Tsoulfas; Maria Aguilera, Lorena; Gustavo, Grecinos; Tamas, Mersich; Daniel, Wettstein; Atul, Suroy; Dhruv, Ghosh; Pranay, Pawar; Gabriele, Kembuan; Peiman, Brouk; Mohammad, Khosravi; Masoud, Mozafari; Ahmed, Adil; Helen, M Mohan; Oded, Zmora; Marco, Fiore; Gallo, G; Francesco, Pata; Gianluca, Pellino; Naoto, Kuroda; Sohei, Satoi; Yuki, Fujimoto; Faris, Ayasra; Mohammad, Chaar; Ildar, R Fakhradiyev; Intisar, Hisham; Jin-Young, Jang; Enver, Fekaj; Mohammad, Jamal; Anvar, Beisembaev; Muhammed, Elhadi; Aiste, Gulla; Luc, Samison; Jupsi, Neny; Palesa, Chisala; April, Roslani; Iran Irani Duran, Sanchez; Laura Martinez Perez, Maldonado; Antonio Ramos De La, Medina; Jade, Nunez; Oumaima, Outani; Abd'Rashid, Nashidengo; Ashish Lal, Shrestha; Rakesh, Shah; Pascal, Jonker; Schelto, Kruijff; Milou, Noltes; Pieter, Steinkamp; Willemijn Van Der, Plas; Chris, Varghese; Deborah, Wright; Jorge, Neira; Adesoji, Ademuyiwa; Babatunde, Osinaike; Justina, Seyi-Olajide; Emmanuel, Williams; Sofija, Pejkova; Knut Magne, Augestad; Kjetil, Soreide; Zainab Al, Balushi; Ahmad, Qureshi; Raza, Sayyed; Mustafa Abu Mohsen, Daraghmeh; Sadi, Abukhalaf; Moises, Cukier; Chris, Munguas; Hugo, Gomez; Sebastian, Shu; Ximena, Vasquez; Marie Dione, Parreno-Sacdalan; Piotr, Major; José, Azevedo; Miguel, Cunha; Irene, Santos; Ahmad, Zarour; Eduard-Alexandru, Bonci; Ionut, Negoi; Sergey, Efetov; Andrey, Litvin; Faustin, Ntirenganya; Ehab, Alameer; Abdourahmane, Ndong; Dejan, Radenkovic; Ibrahim, Sesay; Frederick Koh Hong, Xiang; Chew Min, Hoe; James Ngu Chi, Yong; Arpad, Panyko; Jurij, Kosir; Uros, Bele; Hassan, Ali; Rachel, Moore; Ncamsile, Nhlabathi; Ruth Blanco, Colino; Ana Minaya, Bravo; Umesh, Jayarajah; Dakshitha, Wickramasinghe; Mohammed, Elmujtaba; William, Jebril; Martin, Rutegård; Malin, Sund; Eleftherios, Gialamas; Karoline, Horisberger; Michel, Adamina; Muhammad, Alshaar; Abel, Huang; Ben, Mbwele; Varut, Lohsir
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