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Mortality and pulmonary complications in emergency general surgery patients with COVID-19: A large international multicenter study.
J Trauma Acute Care Surg ; 93(1): 59-65, 2022 07 01.
Article in English | MEDLINE | ID: covidwho-2260331
ABSTRACT

OBJECTIVES:

The outcomes of emergency general surgery (EGS) patients with concomitant COVID-19 infection remain unknown. With a multicenter study in 361 hospitals from 52 countries, we sought to study the mortality and pulmonary complications of COVID-19 patients undergoing EGS.

METHODS:

All patients 17 years or older and diagnosed preoperatively with COVID-19 between February and July 2020 were included. Emergency general surgery was defined as the urgent/emergent performance of appendectomy, cholecystectomy, or laparotomy. The main outcomes were 30-day mortality and 30-day pulmonary complications (a composite of acute respiratory distress syndrome, unexpected mechanical ventilation, or pneumonia). Planned subgroup analyses were performed based on presence of preoperative COVID-related respiratory findings (e.g., cough, dyspnea, need for oxygen therapy, chest radiology abnormality).

RESULTS:

A total of 1,045 patients were included, of which 40.1% were female and 50.0% were older than 50 years; 461 (44.1%), 145 (13.9%), and 439 (42.0%) underwent appendectomy, cholecystectomy, and laparotomy, respectively. The overall mortality rate was 15.1% (158 of 1,045 patients), and the overall pulmonary complication rate was 32.9% (344 of 1,045 patients); in the subgroup of laparotomy patients, the rates were 30.6% (134 of 438 patients) and 59.2% (260 of 439 patients), respectively. Subgroup analyses found mortality and pulmonary complication risk to be especially increased in patients with preoperative respiratory findings.

CONCLUSION:

COVID-19 patients undergoing EGS have significantly high rates of mortality and pulmonary complications, but the risk is most pronounced in those with preoperative respiratory findings. LEVEL OF EVIDENCE Prognostic and Epidemiologic; Level IV.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: General Surgery / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans / Male Language: English Journal: J Trauma Acute Care Surg Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: General Surgery / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans / Male Language: English Journal: J Trauma Acute Care Surg Year: 2022 Document Type: Article