Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
COVIDSurg, Collaborative;GlobalSurg, Collaborative.
Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study.
Anaesthesia. 2021; 76(6): 748-758.
Doi: 10.1111/anae.15458
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- Study Group Mitglieder der Med Uni Graz:
- Andrianakis Alexandros
- Belarmino Armin
- Brinskelle Petra
- Castellani Christoph
- Cohnert Tina Ulrike
- Fediuk Melanie
- Fink Andrea
- Holzmeister Clemens
- Kahn Judith
- Leithner Andreas
- Lindenmann Jörg
- Lumenta David Benjamin
- Michelitsch Birgit
- Nischwitz Sebastian Philipp
- Puchwein Paul
- Schemmer Peter
- Singer Georg
- Smolle-Juettner Freyja-Maria
- Till Holger
- Wolf Axel
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- 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 SARS-CoV-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.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent - administration & dosage
- Adult - administration & dosage
- Aged - administration & dosage
- Aged, 80 and over - administration & dosage
- COVID-19 - administration & dosage
- Child - administration & dosage
- Child, Preschool - administration & dosage
- Cohort Studies - administration & dosage
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- Humans - administration & dosage
- Infant - administration & dosage
- Internationality - administration & dosage
- Male - administration & dosage
- Middle Aged - administration & dosage
- Practice Guidelines as Topic - administration & dosage
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- Find related publications in this database (Keywords)
- COVID-19
- delay
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- surgery
- timing