Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/140021
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Type: | Journal article |
Title: | Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study |
Author: | CovidSurge Collaborative, GlobalSurg Collaborative, |
Citation: | Anaesthesia, 2021; 76(6):748-758 |
Publisher: | Wiley |
Issue Date: | 2021 |
ISSN: | 0003-2409 1365-2044 |
Statement of Responsibility: | COVIDSurg Collaborative and GlobalSurg Collaborative (Australia: Daniel Cox ... Nagendra Dudi-Venkata ... Hidde M Kroon ... Luke Traeger ... Brendon Coventry ... et al.) |
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 SARSCoV- 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. |
Keywords: | CovidSurge Collaborative; GlobalSurg Collaborative |
Rights: | © 2021 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the originalwork is properly cited and is not used for commercial purposes. |
DOI: | 10.1111/anae.15458 |
Published version: | http://dx.doi.org/10.1111/anae.15458 |
Appears in Collections: | Surgery publications |
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hdl_140021.pdf | Published version | 447.77 kB | Adobe PDF | View/Open |
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