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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.
Outcomes and Their State-level Variation in Patients Undergoing Surgery With Perioperative SARS-CoV-2 Infection in the USA. A Prospective Multicenter Study / 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; Pata, Francesco; 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, Lohsiriwat; Shane, Charles; Haithem, Jlassi; Arda, Isik; Sezai, Leventoğlu; Lekuya, Herve; Lekuya, Monka; Herman, Lule; Tom E, F Abbott; Ruth, Benson; Caruna, Ed; Sohini, Chakrabortee; Andreas, Demetriades; Anant, Desai; Thomas, D Drake; John, G Edwards; Jonathan, P Evans; Samuel, Ford; Christina, Fotopoulou; Ewen, Griffiths; Peter, Hutchinson; Michael, D Jenkinson; Tabassum, Khan; Stephen, Knight; Angelos, Kolias; Elaine, Leung; Siobhan, Mckay; Lisa, Norman; Riinu, Ots; Vidya, Raghavan; Keith, Roberts; Andrew, Schache; Richard, Shaw; Katie, Shaw; Neil, Smart; Grant, Stewart; Sudha, Sundar; Dale, Vimalchandran; Naomi, Wright; Slava, Kopetskiy; Sattar, Alshryda; Osaid, Alser; Kerry, Breen; Ian, Ganly; Haytham, Kaafarani; Brittany, Kendall; Hassan, Mashbari; Fernando, Bonilla; Hamza Al Naggar, ; Mayaba, Maimbo; Dennis, Mazingi; Joana F, F Simoes; J Wong, J; Napolitano, L; Hemmila, M; Amin, D; Abramowicz, S; M Roser, S; A Olson, K; Riley, C; Heron, C; Cardenas, T; Leede, E; Thornhill, M; B Haynes, A; Mcelhinney, K; Roward, S; D Trust, M; E Hill, C; G Teixeira, P; Etchill, E; Stevens, K; R Ladd, M; Long, C; Rose, J; Kent, A; Yesantharao, P; Vervoort, D; Jenny, H; Gabre-Kidan, A; Margalit, A; Tsai, L; Malapati, H; Yesantharao, L; Abdou, H; Diaz, J; Richmond, M; Clark, J; O'Meara, L; Hanna, N; Ying, Y; Fleming, J; Ovaitt, A; Gigliotti, J; Fuson, A; Cooper, Z; Salim, A; A Hirji, S; Brown, A; Chung, C; Hansen, L; U Okafor, B; Roxo, V; P Raut, C; S Jolissaint, J; A Mahvi, D; Kaafarani, H; Breen, K; Bankhead-Kendall, B; Alser, O; Mashbari, H; Velmahos, G; R Maurer, L; M El Moheb, ; Gaitanidis, A; Naar, L; A Christensen, M; Kapoen, C; Langeveld, K; M El Hechi, ; Mokhtari, A; H Haqqani, M; T Drake, F; Goldenberg-Sandau, A; Galbreath, B; Reinke, C; Ross, S; Thompson, K; Manning, D; Perkins, R; Eriksson, E; Evans, H; Masrur, M; Giulianotti, P; Benedetti, E; Chang, G; Ourieff, J; Dehart, D; Dorafshar, A; Price, T; R Bhama, A; Torquati, A; Cherullo, E; Kennedy, R; Myers, J; Rubin, K; S Ban, V; G Aoun, S; H Batjer, H; Caruso, J; Carmichael, H; G Velopulos, C; L Wright, F; Urban, S; C McIntyre Jr, R; J Schroeppel, T; A Hennessy, E; Dunn, J; Zier, L; Burlew, C; Coleman, J; P Colling, K; Hall, B; E Rice, H; S Hwang, E; A Olson, S; Moris, D; Verma, R; Hassan, R; Volpe, A; Merola, S; A O'Banion, L; Lilienstein, J; Dirks, R; Marwan, H; Almasri, M; Kulkarni, G; Mehdi, M; Abouassi, A; Abdallah, M; M San Andrés, ; Eid, J; Aigbivbalu, E; Sundaresan, J; George, B; Ssentongo, A; Ssentongo, P; S Oh, J; Hazelton, J; Maines, J; Gusani, N; Garner, M; Horvath, S; Zheng, F; Ujiki, M; Kinnaman, G; Meagher, A; Sharma, I; Holler, E; Mckenzie, K; Chan, J; Fretwell, K; W Nugent 3rd, ; Khalil, A; Chen, D; Post, N; Rostkowski, T; Brahmbhatt, D; Huynh, K; L Hibbard, M; Schellenberg, M; R C, G Martin; Bhutiani, N; Giorgakis, E; Laryea, J; Bhavaraju, A; Sexton, K; Roberts, M; Kost, M; Kimbrough, M; Burdine, L; Kalkwarf, K; Robertson, R; Gosain, A; Camp, L; Lewit, R; P Kronenfeld, J; Urrechaga, E; Goel, N; Rattan, R; Hart, V; Allen, M; Gilna, G; Cioci, A; Ruiz, G; Allen, M; Rakoczy, K; Pavlis, W; Saberi, R; Morris, R; S Karam, B; C E, M Brathwaite; Liu, H; Petrone, P; Hakmi, H; H Sohail, A; Baltazar, G; Heckburn, R; M Nygaard, R; T Colonna, E; W Endorf, F; J Hill, M; Maiga, A; Dennis, B; H Levin, J; Lallemand, M; Choron, R; Peck, G; Soliman, F; Rehman, S; Glass, N; Juthani, B; Deisher, D; M Ruzgar, N; J Ullrich, S; Sion, M; Paranjape, C; M El Moheb, ; R Kar, A; Gillezeau, C; Rapp, J; Taioli, E; A Miles, B; Alpert, N; Podolsky, D; L Coleman, N; P Callahan, M; Ganly, I; Brown, L; J R, T Monson; Dehal, A; Abbas, A; Soliman, A; Kim, B; Jones, C; D Dauer, M; Renza-Stingone, E; Hernandez, E; Gokcen, E; Kropf, E; Sufrin, H; Hirsch, H; Ross, H; Engel, J; Sewards, J; Diaz, J; Poggio, J; Sanserino, K; Rae, L; Philp, M; Metro, M; Mcnelis, P; Petrov, R; Rehman, S; Pazionis, T; Till, B; Lamm, R; J Rios-Diaz, A; Palazzo, F; Rosengart, M; Nicholson, K; M Carrick, M; Rodkey, K; Suri, A; Callcut, R; Nicholson, S; Talathoti, N; Klaristenfeld, D; Biffl, W; Marsh, C; Schaffer, K; E Berndtson, A; Averbach, S; Curry, T; Kwan-Feinberg, R; Consorti, E; Gonzalez, R; Grolman, R; Liu, T; Merzlikin, O; K Abel, M; Ozgediz, D; Boeck, M; Z Kornblith, L; Nunez-Garcia, B; Robinson, B; Park, P; F Utria, A; E Rice-Townsend, S; Javid, P; Hauptman, J; Kieran, K; Nehra, D; Walters, A; Cuschieri, J; H Davidson, G; Nunez, J; Cosker, R; Eckhouse, S; Choudhry, A; Marx, W; Jamil, T; Seegert, S; Al-Embideen, S; Quintana, M; Jackson, H; D Wexner, S; Kent, I; N Martins, P; Xiao, Liu; Alistair, Denniston. - In: ANNALS OF SURGERY. - ISSN 0003-4932. - 275:2(2022), pp. 247-251. [10.1097/SLA.0000000000005310]
Outcomes and Their State-level Variation in Patients Undergoing Surgery With Perioperative SARS-CoV-2 Infection in the USA. A Prospective Multicenter Study
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 Lohsiriwat;Shane Charles;Haithem Jlassi;Arda Isik;Sezai Leventoğlu;Lekuya Herve;Lekuya Monka;Herman Lule;Tom E F Abbott;Ruth Benson;Ed Caruna;Sohini Chakrabortee;Andreas Demetriades;Anant Desai;Thomas D Drake;John G Edwards;Jonathan P Evans;Samuel Ford;Christina Fotopoulou;Ewen Griffiths;Peter Hutchinson;Michael D Jenkinson;Tabassum Khan;Stephen Knight;Angelos Kolias;Elaine Leung;Siobhan McKay;Lisa Norman;Riinu Ots;Vidya Raghavan;Keith Roberts;Andrew Schache;Richard Shaw;Katie Shaw;Neil Smart;Grant Stewart;Sudha Sundar;Dale Vimalchandran;Naomi Wright;Slava Kopetskiy;Sattar Alshryda;Osaid Alser;Kerry Breen;Ian Ganly;Haytham Kaafarani;Brittany Kendall;Hassan Mashbari;Fernando Bonilla;Hamza Al Naggar;Mayaba Maimbo;Dennis Mazingi;Joana F F Simoes;J J Wong;L Napolitano;M Hemmila;D Amin;S Abramowicz;S M Roser;K A Olson;C Riley;C Heron;T Cardenas;E Leede;M Thornhill;A B Haynes;K McElhinney;S Roward;M D Trust;C E Hill;P G Teixeira;E Etchill;K Stevens;M R Ladd;C Long;J Rose;A Kent;P Yesantharao;D Vervoort;H Jenny;A Gabre-Kidan;A Margalit;L Tsai;H Malapati;L Yesantharao;H Abdou;J Diaz;M Richmond;J Clark;L O'Meara;N Hanna;Y Ying;J Fleming;A Ovaitt;J Gigliotti;A Fuson;Z Cooper;A Salim;S A Hirji;A Brown;C Chung;L Hansen;B U Okafor;V Roxo;C P Raut;J S Jolissaint;D A Mahvi;H Kaafarani;K Breen;B Bankhead-Kendall;O Alser;H Mashbari;G Velmahos;L R Maurer;M El Moheb;A Gaitanidis;L Naar;M A Christensen;C Kapoen;K Langeveld;M El Hechi;A Mokhtari;M H Haqqani;F T Drake;A Goldenberg-Sandau;B Galbreath;C Reinke;S Ross;K Thompson;D Manning;R Perkins;E Eriksson;H Evans;M Masrur;P Giulianotti;E Benedetti;G Chang;J Ourieff;D Dehart;A Dorafshar;T Price;A R Bhama;A Torquati;E Cherullo;R Kennedy;J Myers;K Rubin;V S Ban;S G Aoun;H H Batjer;J Caruso;H Carmichael;C G Velopulos;F L Wright;S Urban;R C McIntyre Jr;T J Schroeppel;E A Hennessy;J Dunn;L Zier;C Burlew;J Coleman;K P Colling;B Hall;H E Rice;E S Hwang;S A Olson;D Moris;R Verma;R Hassan;A Volpe;S Merola;L A O'Banion;J Lilienstein;R Dirks;H Marwan;M Almasri;G Kulkarni;M Mehdi;A Abouassi;M Abdallah;M San Andrés;J Eid;E Aigbivbalu;J Sundaresan;B George;A Ssentongo;P Ssentongo;J S Oh;J Hazelton;J Maines;N Gusani;M Garner;S Horvath;F Zheng;M Ujiki;G Kinnaman;A Meagher;I Sharma;E Holler;K McKenzie;J Chan;K Fretwell;W Nugent 3rd;A Khalil;D Chen;N Post;T Rostkowski;D Brahmbhatt;K Huynh;M L Hibbard;M Schellenberg;R C G Martin;N Bhutiani;E Giorgakis;J Laryea;A Bhavaraju;K Sexton;M Roberts;M Kost;M Kimbrough;L Burdine;K Kalkwarf;R Robertson;A Gosain;L Camp;R Lewit;J P Kronenfeld;E Urrechaga;N Goel;R Rattan;V Hart;M Allen;G Gilna;A Cioci;G Ruiz;M Allen;K Rakoczy;W Pavlis;R Saberi;R Morris;B S Karam;C E M Brathwaite;H Liu;P Petrone;H Hakmi;A H Sohail;G Baltazar;R Heckburn;R M Nygaard;E T Colonna;F W Endorf;M J Hill;A Maiga;B Dennis;J H Levin;M Lallemand;R Choron;G Peck;F Soliman;S Rehman;N Glass;B Juthani;D Deisher;N M Ruzgar;S J Ullrich;M Sion;C Paranjape;M El Moheb;A R Kar;C Gillezeau;J Rapp;E Taioli;B A Miles;N Alpert;D Podolsky;N L Coleman;M P Callahan;I Ganly;L Brown;J R T Monson;A Dehal;A Abbas;A Soliman;B Kim;C Jones;M D Dauer;E Renza-Stingone;E Hernandez;E Gokcen;E Kropf;H Sufrin;H Hirsch;H Ross;J Engel;J Sewards;J Diaz;J Poggio;K Sanserino;L Rae;M Philp;M Metro;P McNelis;R Petrov;S Rehman;T Pazionis;B Till;R Lamm;A J Rios-Diaz;F Palazzo;M Rosengart;K Nicholson;M M Carrick;K Rodkey;A Suri;R Callcut;S Nicholson;N Talathoti;D Klaristenfeld;W Biffl;C Marsh;K Schaffer;A E Berndtson;S Averbach;T Curry;R Kwan-Feinberg;E Consorti;R Gonzalez;R Grolman;T Liu;O Merzlikin;M K Abel;D Ozgediz;M Boeck;L Z Kornblith;B Nunez-Garcia;B Robinson;P Park;A F Utria;S E Rice-Townsend;P Javid;J Hauptman;K Kieran;D Nehra;A Walters;J Cuschieri;G H Davidson;J Nunez;R Cosker;S Eckhouse;A Choudhry;W Marx;T Jamil;S Seegert;S Al-Embideen;M Quintana;H Jackson;S D Wexner;I Kent;P N Martins;Xiao Liu;Alistair Denniston
2022
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.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1661768
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.