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BACKGROUND: Patients undergoing surgery with perioperative COVID-19 are suggested to have worse outcomes, but whether this is COVID-related or due to selection bias remains unclear. We aimed to compare the postoperative outcomes of patients with and without perioperative COVID-19. METHODS: Patients with perioperative COVID-19 diagnosed within 7 days before or 30 days after surgery between February and July 2020 from 68 US hospitals in COVIDSurg, an international multicenter database, were 1:1 propensity score matched to patients without COVID-19 undergoing similar procedures in the 2012 American College of Surgeons National Surgical Quality Improvement Program database. The matching criteria included demographics (e.g., age, sex), comorbidities (e.g., diabetes, chronic obstructive pulmonary disease, chronic kidney disease), and operation characteristics (e.g., type, urgency, complexity). The primary outcome was 30-day hospital mortality. Secondary outcomes included hospital length of stay and 13 postoperative complications (e.g., pneumonia, renal failure, surgical site infection). RESULTS: A total of 97,936 patients were included, 1,054 with and 96,882 without COVID-19. Prematching, COVID-19 patients more often underwent emergency surgery (76.1% vs. 10.3%, p < 0.001). A total of 843 COVID-19 and 843 non-COVID-19 patients were successfully matched based on demographics, comorbidities, and operative characteristics. Postmatching, COVID-19 patients had a higher mortality (12.0% vs. 8.1%, p = 0.007), longer length of stay (6 [2-15] vs. 5 [1-12] days), and higher rates of acute renal failure (19.3% vs. 3.0%, p < 0.001), sepsis (13.5% vs. 9.0%, p = 0.003), and septic shock (11.8% vs. 6.0%, p < 0.001). They also had higher rates of thromboembolic complications such as deep vein thrombosis (4.4% vs. 1.5%, p < 0.001) and pulmonary embolism (2.5% vs. 0.4%, p < 0.001) but lower rates of bleeding (11.6% vs. 26.1%, p < 0.001). CONCLUSION: Patients undergoing surgery with perioperative COVID-19 have higher rates of 30-day mortality and postoperative complications, especially thromboembolic, compared with similar patients without COVID-19 undergoing similar surgeries. Such information is crucial for the complex surgical decision making and counseling of these patients. (J Trauma Acute Care Surg. 2023;94: 513-524. Copyright (C) 2023 American Association for the Surgery of Trauma.)LEVEL OF EVIDENCE: Prognostic and Epidemiologic; Level IV.
Is perioperative COVID-19 really associated with worse surgical outcomes? A nationwide COVIDSurg propensity-matched analysis / Dias, Argandykov; Ander, Dorken-Gallastegi; Mohamad, El Moheb; Anthony, Gebran; Jefferson A, Proaño-Zamudio; Mary, Bokenkamp; Angela M, Renne; Dmitri, Nepogodiev; Aneel, Bhangu; Haytham M A, Kaafarani; Siaw-Acheampong, Kwabena; Argus, Leah; Chaudhry, Daoud; E Dawson, Brett; C Glasbey, James; R Gujjuri, Rohan; S Jones, Conor; K Kamarajah, Sivesh; Khatri, Chetan; M Keatley, James; Lawday, Samuel; Li, Elizabeth; Mann, Harvinder; J Marson, Ella; A Mclean, Kenneth; Picciochi, Maria; H Taylor, Elliott; Tiwari, Abhinav; F Simoes, Joana F; M Trout, Isobel; L Venn, Mary; W Wilkin, Richard J; Bhangu, Aneel; Nepogodiev, Dmitri; Dajti, Irida; Gjata, Arben; Boccalatte, Luis; Modolo, Mariamarta; Cox, Daniel; Pockney, Peter; Townend, Philip; Aigner, Felix; Kronberger, Irmgard; Hossain, Kamral; Vanramshorst, Gabrielle; Lawani, Ismail; Ataide, Gustavo; Baiocchi, Glauco; Buarque, Igor; Gohar, Muhammad; Slavchev, Mihail; Agarwal, Arnav; Brar, Amanpreet; Martin, Janet; Marta Modolo, Maria; Olivos, Maricarmen; Calvache, Jose; Jose Perez Rivera, Carlos; Danic Hadzibegovic, Ana; Kopjar, Tomislav; Mihanovic, Jakov; Klat, Jaroslav; Novysedlak, René; Christensen, Peter; El-Hussuna, Alaa; Batista, Sylvia; Lincango, Eddy; H Emile, Sameh; Gebreyohanes Mengesha, Mengistu; Hailu, Samuel; Tamiru, Hailu; Kauppila, Joonas; Laukkarinen, Johanna; Arnaud, Alexis; Albertsmeiers, Markus; Lederhuber, Hans; Loffler, Markus; Tabiri, Stephen; Metallidis, Symeon; Tsoulfas, Georgios; Aguilera Lorena, Maria; Grecinos, Gustavo; Mersich, Tamas; Wettstein, Daniel; Ghosh, Dhruv; Kembuan, Gabriele; Brouk, Peiman; Khosravi, Mohammad; Mozafari, Masoud; Adil, Ahmed; M Mohan, Helen; Zmora, Oded; Fiore, Marco; Gallo, Gaetano; Pata, Francesco; Pellino, Gianluca; Satoi, Sohei; Ayasra, Faris; Chaar, Mohammad; R Fakhradiyev, Ildar; Jamal, Mohammad; Elhadi, Muhammed; Gulla, Aiste; Roslani, April; Martinez, Laura; Ramos De La Medina, Antonio; Outani, Oumaima; Jonker, Pascal; Kruijff, Schelto; Noltes, Milou; Steinkamp, Pieter; van der Plas, Willemijn; Ademuyiwa, Adesoji; Osinaike, Babatunde; Seyi-Olajide, Justina; Williams, Emmanuel; Pejkova, Sofija; Magne Augestad, Knut; Al Balushi, Zainab; Qureshi, Ahmad; Sayyed, Raza; Abu Mohsen Daraghmeh, Mustafa; Abukhalaf, Sadi; Cukier, Moises; Gomez, Hugo; Shu, Sebastian; Vasquez, Ximena; Dione Parreno-Sacdalan, Marie; Major, Piotr; Azevedo, José; Cunha, Miguel; Santos, Irene; Zarour, Ahmad; Bonci, Eduard-Alexandru; Negoi, Ionut; Efetov, Sergey; Litvin, Andrey; Ntirenganya, Faustin; Alameer, Ehab; Radenkovic, Dejan; Koh Hong Xiang, Frederick; Min Hoe, Chew; Ngu Chi Yong, James; Moore, Rachel; Nhlabathi, Ncamsile; Blanco Colino, Ruth; Minaya Bravo, Ana; Minaya-Bravo, Ana; Jayarajah, Umesh; Wickramasinghe, Dakshitha; Elmujtaba, Mohammed; Jebril, William; Rutegård, Martin; Sund, Malin; Isik, Arda; Leventoğlu, Sezai; F Abbott, Tom E; Benson, Ruth; Caruna, Ed; Chakrabortee, Sohini; Demetriades, Andreas; Desai, Anant; D Drake, Thomas; G Edwards, John; P Evans, Jonathan; Ford, Samuel; Fotopoulou, Christina; Griffiths, Ewen; Hutchinson, Peter; D Jenkinson, Michael; Khan, Tabassum; Knight, Stephen; Kolias, Angelos; Leung, Elaine; Mckay, Siobhan; Norman, Lisa; Ots, Riinu; Raghavan, Vidya; Roberts, Keith; Schache, Andrew; Shaw, Richard; Shaw, Katie; Smart, Neil; Stewart, Grant; Sundar, Sudha; Vimalchandran, Dale; Wright, Naomi; Alshryda, Sattar; Alser, Osaid; Breen, Kerry; Ganly, Ian; Kaafarani, Haytham; Kendall, Brittany; Mashbari, Hassan; Al Naggar, Hamza; Mazingi, Dennis; F Simoes, Joana F; 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; 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; 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; H Haqqani, M; T Drake, F; Goldenberg-Sandau, A; Galbreath, B; C, Reinke; S, Ross; K, Thompson; D, Manning; R, Perkins; 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; San Andrés, M; 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; K, Mckenzie; Chan, J; Fretwell, K; Nugent 3rd, W; Khalil, A; Chen, D; Post, N; Rostkowski, T; Brahmbhatt, D; Huynh, K; L Hibbard, M; Schellenberg, M; Rcg, 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; Cem, 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; El Moheb, M; 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; Jrt, Monson; Dehal, A; Abbas, A; Soliman, A; Kim, B; Jones, C; Dauer, E; 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; P, Mcnelis; R, Petrov; S, Rehman; T, Pazionis; 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. - In: THE JOURNAL OF TRAUMA AND ACUTE CARE SURGERY. - ISSN 2163-0755. - 94:4(2023), pp. 513-524. [10.1097/TA.0000000000003859]
Is perioperative COVID-19 really associated with worse surgical outcomes? A nationwide COVIDSurg propensity-matched analysis
Argandykov, Dias;Dorken-Gallastegi, Ander;El Moheb, Mohamad;Gebran, Anthony;Proaño-Zamudio, Jefferson A;Bokenkamp, Mary;Renne, Angela M;Nepogodiev, Dmitri;Bhangu, Aneel;Kaafarani, Haytham M A
;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;Luis Boccalatte;MariaMarta Modolo;Daniel Cox;Peter Pockney;Philip Townend;Felix Aigner;Irmgard Kronberger;Kamral Hossain;Gabrielle VanRamshorst;Ismail Lawani;Gustavo Ataide;Glauco Baiocchi;Igor Buarque;Muhammad Gohar;Mihail Slavchev;Arnav Agarwal;Amanpreet Brar;Janet Martin;Maria Marta Modolo;Maricarmen Olivos;Jose Calvache;Carlos Jose Perez Rivera;Ana Danic Hadzibegovic;Tomislav Kopjar;Jakov Mihanovic;Jaroslav Klat;René Novysedlak;Peter Christensen;Alaa El-Hussuna;Sylvia Batista;Eddy Lincango;Sameh H Emile;Mengistu Gebreyohanes Mengesha;Samuel Hailu;Hailu Tamiru;Joonas Kauppila;Johanna Laukkarinen;Alexis Arnaud;Markus Albertsmeiers;Hans Lederhuber;Markus Loffler;Stephen Tabiri;Symeon Metallidis;Georgios Tsoulfas;Maria Aguilera Lorena;Gustavo Grecinos;Tamas Mersich;Daniel Wettstein;Dhruv Ghosh;Gabriele Kembuan;Peiman Brouk;Mohammad Khosravi;Masoud Mozafari;Ahmed Adil;Helen M Mohan;Oded Zmora;Marco Fiore;Gaetano Gallo;Francesco Pata;Gianluca Pellino;Sohei Satoi;Faris Ayasra;Mohammad Chaar;Ildar R Fakhradiyev;Mohammad Jamal;Muhammed Elhadi;Aiste Gulla;April Roslani;Laura Martinez;Antonio Ramos De La Medina;Oumaima Outani;Pascal Jonker;Schelto Kruijff;Milou Noltes;Pieter Steinkamp;Willemijn van der Plas;Adesoji Ademuyiwa;Babatunde Osinaike;Justina Seyi-Olajide;Emmanuel Williams;Sofija Pejkova;Knut Magne Augestad;Zainab Al Balushi;Ahmad Qureshi;Raza Sayyed;Mustafa Abu Mohsen Daraghmeh;Sadi Abukhalaf;Moises Cukier;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;Dejan Radenkovic;Frederick Koh Hong Xiang;Chew Min Hoe;James Ngu Chi Yong;Rachel Moore;Ncamsile Nhlabathi;Ruth Blanco Colino;Ana Minaya Bravo;Ana Minaya-Bravo;Umesh Jayarajah;Dakshitha Wickramasinghe;Mohammed Elmujtaba;William Jebril;Martin Rutegård;Malin Sund;Arda Isik;Sezai Leventoğlu;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;Sattar Alshryda;Osaid Alser;Kerry Breen;Ian Ganly;Haytham Kaafarani;Brittany Kendall;Hassan Mashbari;Hamza Al Naggar;Dennis Mazingi;Joana F F Simoes;Wong J J;Napolitano L;Hemmila M;Amin D;Abramowicz S;Roser S M;Olson K A;Riley C;Heron C;Cardenas T;Leede E;Thornhill M;Haynes A B;McElhinney K;Roward S;Trust M D;Hill C E;Teixeira P G;Etchill E;Stevens K;Ladd M R;Long C;Rose J;Kent A;Yesantharao P;Vervoort D;Jenny H;Gabre-Kidan A;Margalit A;Tsai L;Malapati H;Yesantharao L;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;Kaafarani H;Breen K;Bankhead-Kendall B;Alser O;Mashbari H;Velmahos G;Maurer L R;El Moheb M;Gaitanidis A;Naar L;Christensen M A;Kapoen C;Langeveld K;El Hechi M;Mokhtari A;M H Haqqani;F T Drake;A Goldenberg-Sandau;B Galbreath;Reinke C;Ross S;Thompson K;Manning D;Perkins R;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;McKenzie K;J Chan;K Fretwell;W Nugent 3rd;A Khalil;D Chen;N Post;T Rostkowski;D Brahmbhatt;K Huynh;M L Hibbard;M Schellenberg;Martin Rcg;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;Brathwaite Cem;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;Monson Jrt;A Dehal;A Abbas;A Soliman;B Kim;C Jones;E 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;McNelis P;Petrov R;Rehman S;Pazionis T;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
2023
Abstract
BACKGROUND: Patients undergoing surgery with perioperative COVID-19 are suggested to have worse outcomes, but whether this is COVID-related or due to selection bias remains unclear. We aimed to compare the postoperative outcomes of patients with and without perioperative COVID-19. METHODS: Patients with perioperative COVID-19 diagnosed within 7 days before or 30 days after surgery between February and July 2020 from 68 US hospitals in COVIDSurg, an international multicenter database, were 1:1 propensity score matched to patients without COVID-19 undergoing similar procedures in the 2012 American College of Surgeons National Surgical Quality Improvement Program database. The matching criteria included demographics (e.g., age, sex), comorbidities (e.g., diabetes, chronic obstructive pulmonary disease, chronic kidney disease), and operation characteristics (e.g., type, urgency, complexity). The primary outcome was 30-day hospital mortality. Secondary outcomes included hospital length of stay and 13 postoperative complications (e.g., pneumonia, renal failure, surgical site infection). RESULTS: A total of 97,936 patients were included, 1,054 with and 96,882 without COVID-19. Prematching, COVID-19 patients more often underwent emergency surgery (76.1% vs. 10.3%, p < 0.001). A total of 843 COVID-19 and 843 non-COVID-19 patients were successfully matched based on demographics, comorbidities, and operative characteristics. Postmatching, COVID-19 patients had a higher mortality (12.0% vs. 8.1%, p = 0.007), longer length of stay (6 [2-15] vs. 5 [1-12] days), and higher rates of acute renal failure (19.3% vs. 3.0%, p < 0.001), sepsis (13.5% vs. 9.0%, p = 0.003), and septic shock (11.8% vs. 6.0%, p < 0.001). They also had higher rates of thromboembolic complications such as deep vein thrombosis (4.4% vs. 1.5%, p < 0.001) and pulmonary embolism (2.5% vs. 0.4%, p < 0.001) but lower rates of bleeding (11.6% vs. 26.1%, p < 0.001). CONCLUSION: Patients undergoing surgery with perioperative COVID-19 have higher rates of 30-day mortality and postoperative complications, especially thromboembolic, compared with similar patients without COVID-19 undergoing similar surgeries. Such information is crucial for the complex surgical decision making and counseling of these patients. (J Trauma Acute Care Surg. 2023;94: 513-524. Copyright (C) 2023 American Association for the Surgery of Trauma.)LEVEL OF EVIDENCE: Prognostic and Epidemiologic; Level IV.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1681689
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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.