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

To assess the association between the timing of surgery relative to the development of Covid-19 and the risks of postoperative complications. It is unknown whether patients who recovered from Covid-19 and then underwent a major elective operation have an increased risk of developing postoperative co...

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Vydané v:Annals of surgery Ročník 275; číslo 2; s. 242
Hlavní autori: Deng, John Z, Chan, Janine S, Potter, Alexandra L, Chen, Ya-Wen, Sandhu, Harpal S, Panda, Nikhil, Chang, David C, Yang, Chi-Fu Jeffrey
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States 01.02.2022
Predmet:
COVID-19 - diagnosis
COVID-19 Testing
Elective Surgical Procedures - adverse effects
Humans
Pneumonia - diagnosis
Postoperative Complications - diagnosis
Pulmonary Embolism - diagnosis
Respiratory Insufficiency - diagnosis
Risk Factors
SARS-CoV-2
Sepsis - diagnosis
Time-to-Treatment
United States
United States
ISSN:1528-1140, 1528-1140
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Shrnutí:To assess the association between the timing of surgery relative to the development of Covid-19 and the risks of postoperative complications. 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. 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"). 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. 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.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1528-1140
1528-1140
DOI:10.1097/SLA.0000000000005308