Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study

Autor: Nepogodiev, D, Simoes, JFF, Li, E, AlAmeer, E, El-Boghdadly, K, Wuraola, F, Lule, H, Kaafarani, H, Khosravi, M, Kronberger, I, Leventoglu, S, Mengistu, GM, Modolo, MM, Ntirenganya, F, Pius, R, Qureshi, AU, Bhangu, A, Omar, OM, Ahmed, WUR, Argus, L, Ball, A, Bywater, EP, Blanco-Colino, R, Chaudhry, D, Dawson, BE, Duran, I, Glasbey, JC, Gujjuri, RR, Jones, CS, Harrison, EM, Kamarajah, SK, Keatley, JM, Lawday, S, Mann, H, Marson, EJ, Mclean, KA, Norman, L, Ots, R, Outani, O, Picciochi, M, Santos, I, Shaw, C, Taylor, EH, Trout, IM, Varghese, C, Venn, ML, Xu, W, Dajti, I, Gjata, A, Kacimi, SEO, Boccalatte, L, Cox, D, Pockney, P, Townend, P, Aigner, F, Kronberger, IE, Samadov, E, Alderazi, A, Hossain, K, Padmore, G, van Ramshorst, G, Lawani, I, Cerovac, A, Delibegovic, S, Baiocchi, G, Gomes, GMA, Buarque, IL, Gohar, M, Slavchev, M, Nwegbu, C, Agarwal, A, Brar, A, Martin, J, Ng-Kamstra, J, Olivos, M, Lou, WH, Ren, DL, Calvache, JA, Rivera, CJP, Hadzibegovic, AD, Kopjar, T, Mihanovic, J, Jimenez, PMA, Gouvas, N, Klat, J, Novysedlak, R, Amisi, N, Christensen, P, El-Hussuna, A, Batista, S, Lincango-Naranjo, E, Emile, S, Sandoval, DAA, Dhufera, H, Hailu, S, Mengesha, MG, Kauppila, JH, Arnaud, AP, Demetrashvili, Z, Albertsmeier, M, Lederhuber, H, Loffler, MW, Acquah, DK, Ofori, B, Tabiri, S, Metallidis, S, Tsoulfas, G, Aguilera-Arevalo, ML, Recinos, G, Mersich, T, Wettstein, D, Ghosh, D, Kembuan, G, Milan, PB, Khosravi, MH, Mozafari, M, Hilmi, A, Mohan, H, Zmora, O, Gallo, G, Pata, F, Pellino, G, Fujimoto, Y, Kuroda, N, Satoi, S, Abou Chaar, MK, Ayasra, F, Fakhradiyev, I, Hamdun, IHS, Jin-Young, J, Jamal, M, Karout, L, Elhadi, M, Gulla, A, Rasoaherinomenjanahary, F, Samison, LH, Roslani, AC, Sanchez, IID, Gonzalez, DS, Martinez, L, Martinez, MJ, Nayen, A, Ramos-De la Medina, A, Sánchez-López, A., Sánchez-Cabús S., GlobalSurg Collaborative
Rok vydání: 2021
Předmět:
Zdroj: ANAESTHESIA
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname
ISSN: 0003-2409
Popis: Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1% (3.3-4.8), 3.9% (2.6-5.1) and 3.6% (2.0-5.2), respectively). Surgery performed >= 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5% (0.9-2.1%)). After a >= 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0%), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms >= 7 weeks from diagnosis may benefit from further delay.
Databáze: OpenAIRE
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