Insights into Perioperative COVID-19 Impact on Surgical Outcomes
This study delves into the impact of perioperative SARS-CoV-2 infection on surgical outcomes, focusing on 30-day mortality rates and pulmonary complications. Key findings include associations with demographic factors, surgery type, and postoperative pathways, providing valuable insights for healthcare providers.
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Presentation Transcript
Covidsurg publications Claire Newton Consultant Gynaecological Oncologist
Lancet 2020; 396: 2738 reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection 235 hospitals in 24 countries had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery 1128 patients who had surgery between Jan 1 and March 31, 2020. 835 (74 0%) had emergency surgery and 280 (24 8%) had elective surgery.
30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (51 2%) of 1128 patients; 30-day mortality in these patients was 38 0% (219 of 577), accounting for 81 7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1 75 [95% CI 1 28 2 40],p<0 0001), age 70 years or older versus younger than 70 years (2 30 [1 65 3 22], p<0 0001), American Society of Anesthesiologists grades 3 5 versus grades 1 2 (2 35 [1 57 3 53], p<0 0001), malignant versus benign or obstetric diagnosis (1 55 [1 01 2 39], p=0 046), emergency versus elective surgery (1 67 [1 06 2 63], p=0 026), major versus minor surgery (1 52 [1 01 2 31], p=0 047).
J Clin Oncol. 2020 Oct 6:JCO2001933. doi: 10.1200/JCO.20.01933.J Clin Oncol. 2020. PMID: 33021869 Aim: determine whether COVID-19 free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. 9,171 patients from 447 hospitals in 55 countries 2481 (27.1%) COVID-free vs 6690 (72.9%) patients no defined pathway 10 solid tumour types
Younger and less comorbidities in COVID-free pathway pulmonary complication rates were lower with COVID-19 free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). The postoperative SARS-CoV-2 infection rate was also lower in COVID-19 free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76).
