Attenzione: i dati modificati non sono ancora stati salvati. Per confermare inserimenti o cancellazioni di voci è necessario confermare con il tasto SALVA/INSERISCI in fondo alla pagina
IRIS
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. LEVEL OF EVIDENCE Prognostic and Epidemiologic; Level IV.
Is perioperative COVID-19 really associated with worse surgical outcomes? A nationwide COVIDSurg propensity-matched analysis
Argandykov D.;Dorken-Gallastegi A.;El Moheb M.;Gebran A.;Proano-Zamudio J. A.;Bokenkamp M.;Renne A. M.;Nepogodiev D.;Bhangu A.;Kaafarani H. M. A.;Siaw-Acheampong K.;Argus L.;Chaudhry D.;Dawson B. E.;Glasbey J. C.;Gujjuri R. R.;Jones C. S.;Kamarajah S. K.;Khatri C.;Keatley J. M.;Lawday S.;Li E.;Mann H.;Marson E. J.;McLean K. A.;Picciochi M.;Taylor E. H.;Tiwari A.;Simoes J. F. F.;Trout I. M.;Venn M. L.;Wilkin R. J. W.;Bhangu A.;Nepogodiev D.;Dajti I.;Gjata A.;Boccalatte L.;Modolo M.;Cox D.;Pockney P.;Townend P.;Aigner F.;Kronberger I.;Hossain K.;Vanramshorst G.;Lawani I.;Ataide G.;Baiocchi G.;Buarque I.;Gohar M.;Slavchev M.;Agarwal A.;Brar A.;Martin J.;Modolo M. M.;Olivos M.;Calvache J.;Rivera C. J. P.;Hadzibegovic A. D.;Kopjar T.;Mihanovic J.;Klat J.;Novysedlak R.;Christensen P.;El-Hussuna A.;Batista S.;Lincango E.;Emile S. H.;Mengesha M. G.;Hailu S.;Tamiru H.;Kauppila J.;Laukkarinen J.;Arnaud A.;Albertsmeiers M.;Lederhuber H.;Loffler M.;Tabiri S.;Metallidis S.;Tsoulfas G.;Lorena M. A.;Grecinos G.;Mersich T.;Wettstein D.;Ghosh D.;Kembuan G.;Brouk P.;Khosravi M.;Mozafari M.;Adil A.;Mohan H. M.;Zmora O.;Fiore M.;Gallo G.;Pata F.;Pellino G.;Satoi S.;Ayasra F.;Chaar M.;Fakhradiyev I. R.;Jamal M.;Elhadi M.;Gulla A.;Roslani A.;Martinez L.;De La Medina A. R.;Outani O.;Jonker P.;Kruijff S.;Noltes M.;Steinkamp P.;Van Der Plas W.;Ademuyiwa A.;Osinaike B.;Seyi-Olajide J.;Williams E.;Pejkova S.;Augestad K. M.;Al Balushi Z.;Qureshi A.;Sayyed R.;Daraghmeh M. A. M.;Abukhalaf S.;Cukier M.;Gomez H.;Shu S.;Vasquez X.;Parreno-Sacdalan M. D.;Major P.;Azevedo J.;Cunha M.;Santos I.;Zarour A.;Bonci E. -A.;Negoi I.;Efetov S.;Litvin A.;Ntirenganya F.;Alameer E.;Radenkovic D.;Xiang F. K. H.;Hoe C. M.;Yong J. N. C.;Moore R.;Nhlabathi N.;Colino R. B.;Bravo A. M.;Minaya-Bravo A.;Jayarajah U.;Wickramasinghe D.;Elmujtaba M.;Jebril W.;Rutegard M.;Sund M.;Isik A.;Leventoglu S.;Abbott T. E. F.;Benson R.;Caruna E.;Chakrabortee S.;Demetriades A.;Desai A.;Drake T. D.;Edwards J. G.;Evans J. P.;Ford S.;Fotopoulou C.;Griffiths E.;Hutchinson P.;Jenkinson M. D.;Khan T.;Knight S.;Kolias A.;Leung E.;McKay S.;Norman L.;Ots R.;Raghavan V.;Roberts K.;Schache A.;Shaw R.;Shaw K.;Smart N.;Stewart G.;Sundar S.;Vimalchandran D.;Wright N.;Alshryda S.;Alser O.;Breen K.;Ganly I.;Kaafarani H.;Kendall B.;Mashbari H.;Al Naggar H.;Mazingi D.;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.;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.;Hirji S. A.;Brown A.;Chung C.;Hansen L.;Okafor B. U.;Roxo V.;Raut C. P.;Jolissaint J. S.;Mahvi D. A.;Kaafarani H.;Breen K.;Bankhead-Kendall B.;Alser O.;Mashbari H.;Velmahos G.;Maurer L. R.;MEl Moheb M.;Gaitanidis A.;Naar L.;Christensen M. A.;Kapoen C.;Langeveld K.;El Hechi M.;Mokhtari A.;Haqqani M. H.;Drake F. T.;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.;Bhama A. R.;Torquati A.;Cherullo E.;Kennedy R.;Myers J.;Rubin K.;Ban V. S.;Aoun S. G.;Batjer H. H.;Caruso J.;Carmichael H.;Velopulos C. G.;Wright F. L.;Urban S.;McIntyre R. C.;Schroeppel T. J.;Hennessy E. A.;Dunn J.;Zier L.;Burlew C.;Coleman J.;Colling K. P.;Hall B.;Rice H. E.;Hwang E. S.;Olson S. A.;Moris D.;Verma R.;Hassan R.;Volpe A.;Merola S.;O'Banion L. A.;Lilienstein J.;Dirks R.;Marwan H.;Almasri M.;Kulkarni G.;Mehdi M.;Abouassi A.;Abdallah M.;San Andres M.;Eid J.;Aigbivbalu E.;Sundaresan J.;George B.;Ssentongo A.;Ssentongo P.;Oh J. S.;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.;Nugent W.;Khalil A.;Chen D.;Post N.;Rostkowski T.;Brahmbhatt D.;Huynh K.;Hibbard M. L.;Schellenberg M.;Rcg M.;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.;Kronenfeld J. P.;Urrechaga E.;Goel N.;Rattan R.;Hart V.;Gilna G.;Cioci A.;Ruiz G.;Allen M.;Rakoczy K.;Pavlis W.;Saberi R.;Morris R.;Karam B. S.;Cem B.;Liu H.;Petrone P.;Hakmi H.;Sohail A. H.;Baltazar G.;Heckburn R.;Nygaard R. M.;Colonna E. T.;Endorf F. W.;Hill M. J.;Maiga A.;Dennis B.;Levin J. H.;Lallemand M.;Choron R.;Peck G.;Soliman F.;Rehman S.;Glass N.;Juthani B.;Deisher D.;Ruzgar N. M.;Ullrich S. J.;Sion M.;Paranjape C.;El Moheb M.;Kar A. R.;Gillezeau C.;Rapp J.;Taioli E.;Miles B. A.;Alpert N.;Podolsky D.;Coleman N. L.;Callahan M. P.;Ganly I.;Brown L.;Jrt M.;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.;Poggio J.;Sanserino K.;Rae L.;Philp M.;Metro M.;McNelis P.;Petrov R.;Pazionis T.;Till B.;Lamm R.;Rios-Diaz A. J.;Palazzo F.;Rosengart M.;Nicholson K.;Carrick M. M.;Rodkey K.;Suri A.;Callcut R.;Nicholson S.;Talathoti N.;Klaristenfeld D.;Biffl W.;Marsh C.;Schaffer K.;Berndtson A. E.;Averbach S.;Curry T.;Kwan-Feinberg R.;Consorti E.;Gonzalez R.;Grolman R.;Liu T.;Merzlikin O.;Abel M. K.;Ozgediz D.;Boeck M.;Kornblith L. Z.;Nunez-Garcia B.;Robinson B.;Park P.;Utria A. F.;Rice-Townsend S. E.;Javid P.;Hauptman J.;Kieran K.;Nehra D.;Walters A.;Cuschieri J.;Davidson G. H.;Nunez J.;Cosker R.;Eckhouse S.;Choudhry A.;Marx W.;Jamil T.;Seegert S.;Al-Embideen S.;Quintana M.;Jackson H.;Wexner S. D.;Kent I.;Martins P. N.
2023-01-01
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. LEVEL OF EVIDENCE Prognostic and Epidemiologic; Level IV.
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11770/357660
Attenzione
Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo
Citazioni
ND
12
11
social impact
Conferma cancellazione
Sei sicuro che questo prodotto debba essere cancellato?
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.
