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Risk Factors Associated With Postoperative Mortality Among COVID-19 Positive Patients: Results of 3027 Operations and Procedures.
Yilmaz, Sumeyye; Sapci, Ipek; Jia, Xue; Argalious, Maged; Taylor, Mark A; Ridgeway, Beri M; Haber, Georges-Pascal; Steele, Scott R.
  • Yilmaz S; Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Main Campus, Cleveland, OH.
  • Sapci I; Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Main Campus, Cleveland, OH.
  • Jia X; Department of Quantitative Health Sciences, Cleveland Clinic Main Campus, Cleveland, OH.
  • Argalious M; Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic Main Campus, Cleveland, OH.
  • Taylor MA; Department of Surgical Operations, Anesthesiology Institute, Cleveland Clinic Main Campus, Cleveland, OH.
  • Ridgeway BM; Division of Urogynecology and Pelvic Floor Disorders, Women's Health Institute, Cleveland Clinic Main Campus, Cleveland, OH.
  • Haber GP; Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Main Campus, Cleveland, OH.
  • Steele SR; Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Main Campus, Cleveland, OH.
Ann Surg ; 276(6): 969-974, 2022 Dec 01.
Article in English | MEDLINE | ID: covidwho-2037601
ABSTRACT

OBJECTIVE:

To investigate the predictors of postoperative mortality in coronavirus disease 2019 (COVID-19)-positive patients.

BACKGROUND:

COVID-19-positive patients have more postoperative complications. Studies investigating the risk factors for postoperative mortality in COVID-19-positive patients are limited.

METHODS:

COVID-19-positive patients who underwent surgeries/procedures in Cleveland Clinic between January 2020 and March 2021 were identified retrospectively. The primary outcome was postoperative/procedural 30-day mortality. Secondary outcomes were length of stay, intensive care unit admission, and 30-day readmission.

RESULTS:

A total of 2543 patients who underwent 3027 surgeries/procedures were included. Total 48.5% of the patients were male. The mean age was 57.8 (18.3) years. A total of 71.2% had at least 1 comorbidity. Total 78.7% of the cases were elective. The median operative time was 94 (47.0-162) minutes and mean length of stay was 6.43 (13.4) days. Postoperative/procedural mortality rate was 4.01%. Increased age [odds ratio (OR) 1.66, 95% CI, 1.4-1.98; P <0.001], being a current smoker [2.76, (1.3-5.82); P =0.008], presence of comorbidity [3.22, (1.03-10.03); P =0.043], emergency [6.35, (3.39-11.89); P <0.001] and urgent versus [1.78, (1.12-2.84); P =0.015] elective surgery, admission through the emergency department [15.97, (2.00-127.31); P =0.009], or inpatient service [32.28, (7.75-134.46); P <0.001] versus outpatients were associated with mortality in the multivariable analysis. Among all specialties, thoracic surgery [3.76, (1.66-8.53); P =0.002] had the highest association with mortality. Total 17.5% of the patients required intensive care unit admission with increased body mass index being a predictor [1.03, (1.01-1.05); P =0.005].

CONCLUSIONS:

COVID-19-positive patients have higher risk of postintervention mortality. Risk factors should be carefully evaluated before intervention. Further studies are needed to understand the impact of pandemic on long-term surgical/procedural outcomes.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Language: English Journal: Ann Surg Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Language: English Journal: Ann Surg Year: 2022 Document Type: Article