Pre-operative prevalence of asymptomatic carriers of COVID-19 in hospitals in Catalonia during the first wave after the resumption of surgical activity.

INTRODUCTION: The COVID-19 pandemic led to the cancellation of non-essential surgical procedures in March 2020. With the resumption of surgical activity, patients undergoing surgery were one of the first population groups to be systematically tested for PCR. The aim of this study was to determine the prevalence of asymptomatic SARS-CoV-2 carriers after the resumption of non-essential surgical activity. METHODS: Retrospective multicenter observational study of patients scheduled for surgery or undergoing emergency surgery in Catalonia between 20 April and 31 May 2020. The microbiological results of preoperative PCR tests and clinical records were reviewed, and an epidemiological survey was conducted on patients with positive PCR for SARS-CoV-2. RESULTS: A total of 10,838 patients scheduled for surgery or who underwent emergency surgery were screened for COVID-19. One hundred and eighteen patients (1.09%) were positive for SARS-CoV-2 in the 72 h prior to surgery. The prevalence of asymptomatic carriers was 0.7% (IC95%: 0.6%-0.9%). The first week of the study presented the highest prevalence of asymptomatic carriers [1.9% (CI95%:1.1%-3.2%)]. CONCLUSIONS: The low levels of asymptomatic carriers of COVID-19 infection obtained in the surgical population of hospitals in Catalonia after the resumption of surgical activity, shows that most patients were able to undergo surgical procedures without the risks of COVID-19 associated complications in the perioperative period.

Pre-operative prevalence of asymptomatic carriers of COVID-19 in hospitals in Catalonia during the first wave after the resumption of surgical activity. / Prevalencia preoperatoria de portadores asintomáticos de COVID-19 en hospitales de Cataluña durante la primera ola tras el reinicio de la actividad quirúrgica.

INTRODUCTION: The COVID-19 pandemic led to the cancellation of non-essential surgical procedures in March 2020. With the resumption of surgical activity, patients undergoing surgery were one of the first population groups to be systematically tested for PCR. The aim of this study was to determine the prevalence of asymptomatic SARS-CoV-2 carriers after the resumption of non-essential surgical activity. METHODS: Retrospective multicenter observational study of patients scheduled for surgery or undergoing emergency surgery in Catalonia between 20 April and 31 May 2020. The microbiological results of preoperative PCR tests and clinical records were reviewed, and an epidemiological survey was conducted on patients with positive PCR for SARS-CoV-2. RESULTS: A total of 10,838 patients scheduled for surgery or who underwent emergency surgery were screened for COVID-19. One hundred and eighteen patients (1.09%) were positive for SARS-CoV-2 in the 72hours prior to surgery. The prevalence of asymptomatic carriers was 0.7% (95%CI: 0.6% - 0.9%). The first week of the study presented the highest prevalence of asymptomatic carriers [1.9% (95%CI: 1.1%-3.2%)]. CONCLUSIONS: The low levels of asymptomatic carriers of COVID-19 infection obtained in the surgical population of hospitals in Catalonia after the resumption of surgical activity, shows that most patients were able to undergo surgical procedures without the risks of COVID-19 associated complications in the perioperative period.

Náuseas y vómitos postoperatorios en cirugía mayor traumatológica / Postoperative nausea and vomiting in major trauma surgery

Objetivo: Las náuseas y vómitos son complicaciones frecuentes durante el postoperatorio, causan un gran malestar en el paciente y pueden aumentar la morbilidad. El objetivo de nuestro estudio es determinar la prevalencia de náuseas y vómitos postoperatorios (NVPO), qué factores influyen en su aparición y obtener un modelo predictivo de factores pronóstico. Método Se realizó un estudio observacional prospectivo a 201 pacientes intervenidos de cirugía mayor Traumatológica y Ortopédica en el año 2008. Para la recogida de datos se elaboró un cuestionario que constaba de los datos demográficos del paciente, de los intraoperatorios, de los postoperatorios y del registro del tratamiento antiemético postoperatorio según el protocolo del servicio. Resultados Presentaron NVPO el 39,8% de los pacientes. Del total de mujeres padecieron NVPO el 46,6% y el 75% eran pacientes con antecedentes de NVPO previos. Se obtuvo mayor prevalencia en cirugías consideradas más agresivas. El horario en el que hubo mayor número de episodios fue a las 17 y 19 h PM y a las 8 h a. m. Obtuvimos nuestro modelo predictivo a partir de la siguiente fórmula: Y (probabilidad de náuseas y vómitos)=−1,334+0,753*S+1,5602*NVP+0,769*IQa. Conclusiones La prevalencia de NVPO en este estudio ha sido elevada, ya que más de un tercio de la población estudiada las presentaron. El modelo predictivo nos permitirá saber cuál es el riesgo de cada paciente de padecer NVPO, y por lo tanto marcará la estrategia terapéutica tanto preoperatoria como postoperatoria. Ser mujer, tener antecedentes de náuseas y vómitos previos y estar sometido a una cirugía agresiva son factores de riesgo. La movilización del paciente y las visitas de los familiares producen mayor número de episodios de NVPO (AU)

Objective: Postoperative nausea and vomiting (PONV) are common complications during the postoperative period, causing important discomfort to the patient and also can increase morbidity. The objective of our article is to predict the prevalence of postoperative nausea and vomiting, the factors that have an influence on its appearance, and to obtain a predictive model based on prognostic factors. Method: A prospective observational study was conducted on 201 patients who underwent major Orthopaedic and Trauma surgery during the year 2008. A questionnaire was designed to collect the required data as established previously by a standardized protocol, in which was requested, patient demographics, intraoperative and postoperative data, as well as details on any antiemetic treatment that was needed in the recovery ward. Results: A total of 39.8% patients suffered PONV. Of the females, 46.6% suffered PONV, and 75% had previous history of PONV. A higher prevalence was observed in patients who were subjected to more aggressive surgery. There was a concentration of cases between 5 pm and 7 pm, and also at 8 am. The predictive model was obtained from this formula: Y = −1,334 + 0,753*S + 1,5602*NVP + 0,769*IQa. Conclusions: The prevalence of PONV in this study has been high, as more a third of the studied population suffered from it. The predictive model should help determine the specific risk of each patient of suffering from PONV, thus being able to define a therapeutic strategy during the preoperative period as well as during the postoperative period. Being female, a previous history of PONV, and undergoing an aggressive surgical procedure are risk factors. Patient mobilization and family visits increase the number of PONV episodes (AU)

[Postoperative nausea and vomiting in major trauma surgery]. / Náuseas y vómitos postoperatorios en cirugía mayor traumatológica.

OBJECTIVE: Postoperative nausea and vomiting (PONV) are common complications during the postoperative period, causing important discomfort to the patient and also can increase morbidity. The objective of our article is to predict the prevalence of postoperative nausea and vomiting, the factors that have an influence on its appearance, and to obtain a predictive model based on prognostic factors. METHOD: A prospective observational study was conducted on 201 patients who underwent major Orthopaedic and Trauma surgery during the year 2008. A questionnaire was designed to collect the required data as established previously by a standardized protocol, in which was requested, patient demographics, intraoperative and postoperative data, as well as details on any antiemetic treatment that was needed in the recovery ward. RESULTS: A total of 39.8% patients suffered PONV. Of the females, 46.6% suffered PONV, and 75% had previous history of PONV. A higher prevalence was observed in patients who were subjected to more aggressive surgery. There was a concentration of cases between 5 pm and 7 pm, and also at 8 am. The predictive model was obtained from this formula: Y= -1,334 + 0,753*S + 1,5602*NVP + 0,769*IQa CONCLUSIONS: The prevalence of PONV in this study has been high, as more a third of the studied population suffered from it. The predictive model should help determine the specific risk of each patient of suffering from PONV, thus being able to define a therapeutic strategy during the preoperative period as well as during the postoperative period. Being female, a previous history of PONV, and undergoing an aggressive surgical procedure are risk factors. Patient mobilization and family visits increase the number of PONV episodes.