For a study, researchers sought to describe the 30-day outcomes of patients in the United States who had a perioperative SARS-CoV-2 infection and were undergoing surgery. There was uncertainty about the postoperative hazards of SARS-CoV-2 patients. All patients under the age of 17 who underwent surgery with perioperative SARS-CoV-2 infection between January 1 and June 30, 2020, in 70 hospitals across 27 states were enrolled in the COVIDSurg multicenter trial. About 30-day mortality and pulmonary problems were the major endpoints. To find predictors of mortality, investigators used multivariable analyses (controlling for demographics, comorbidities, and procedural features). There were 1,581 patients in all, with more than half of them being men (n=822, 52.0%) and older than 50 years (n=835, 52.8%). The majority of procedures (n=1261, or 79.8%) were emergency, as were laparotomies (n=538, or 34.1%). The mortality and pulmonary complication rates were respectively 11.0 and 39.5%. Male sex (2.26 [1.53–3.35]), ASA grades 3–5 (3.08 [1.60–5.95]), emergency surgery (2.44 [1.31–4.54]), malignancy (2.97 [1.58–5.57]), respiratory comorbidities (2.08 [1.30–3.32]), and higher Revised Cardiac Risk Index (1.20 [1.02–1.41] were all independent predictors of mortality. While statewide elective cancellation orders were not linked to lower mortality, a sub-analysis found that it was linked to lower mortality in people who had elective surgery (0.14 [0.03–0.61]). Patients with perioperative SARS-CoV-2 infection, particularly senior males, had a much higher risk of surgical sequelae. When possible, postponing elective surgery and opting for non-operative therapy should be explored in the United States during pandemic peaks.

 

Source:journals.lww.com/annalsofsurgery/Abstract/2022/02000/Outcomes_and_Their_State_level_Variation_in.8.aspx