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Forschungsdatenbank PMU-SQQUID

Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study.
Nepogodiev, D.; COVIDSurg Collaborative; GlobalSurg Collaborative] NIHR Global Hlth Res Unit Global Surg, Birmingham, W Midlands, England
Anaesthesia. 2021; 76(6): 74-758.
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en

Becker Johannes
Bittner Reinhard
Borhanian Kurosch
Dornauer Isabella
Emmanuel Klaus
Gabersek Ana
Gantschnigg Antonia
Grechenig Michael
Gruber Ricarda
Hutter Jörg
Jäger Tarkan
Koch Oliver Owen
Lechner Michael
Manzenreiter Lisa
Mühlbacher Iris
Presl Jaroslav
Russe Elisabeth
Schredl Philipp
Schwaiger Karl
Varga Martin
Wechselberger Gottfried
Weitzendorfer Michael
Wimmer Angela

Abstract

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.


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