Perioperative morbidity and mortality in patients undergoing elective and emergency surgery during COVID-19 pandemic in a fourth level hospital
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Keywords

COVID-19
mortality
morbidity
Incidence
outcomes
Surgical procedures

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Perioperative morbidity and mortality in patients undergoing elective and emergency surgery during COVID-19 pandemic in a fourth level hospital. (2024). Universitas Medica, 64(4). https://doi.org/10.11144/Javeriana.umed64-4.mmpc
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Abstract

Introduction: During the SARS-CoV-2 pandemic, an increase in perioperative morbidity and mortality was described in the period previous to SARS-CoV-2 vaccination.

Objective: The objective of the study was to determine the cumulative incidence of COVID-19 and global mortality 30 days after the procedure in patients undergoing surgery.

Methodology: Retrospective cohort of 314 patients who underwent surgery between 03/06/2020 and 06/30/2021. These patients were randomly selected. Preoperatively RT-PCR for SARS-CoV-2 was taken in all patients, and postoperatively in patients with new onset of symptoms.

Results:  At 30 days after the surgical intervention, a cumulative incidence of COVID-19 of 0.97% and a global mortality of 2.2% were found. In patients with perioperative SARS-CoV-2, the 30-day mortality was 42.8%.

Conclusion: The cumulative incidence of COVID-19 was similar to other cohorts' reports, a high 30-day mortality in patients with perioperative SARS-CoV-2 was observed among these patients, which reinforces the importance of perioperative prevention measures, as well as the prioritization of surgical procedures and the need of universal vaccination.

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COVIDSurg Collaborative; GlobalSurg Collaborative. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia. 2021 Jun;76(6):748-58. https://doi.org/10.1111/anae.15458

International Surgical Outcomes Study Group. Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries. Br J Anaesth. 2016 Oct 31;117(5):601-9. https://doi.org/10.1093/bja/aew316

GlobalSurg Collaborative. Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study. Lancet Infect Dis. 2018 May;18(5):516-25. https://doi.org/10.1016/S1473-3099(18)30101-4

COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020 Jul 4;396(10243):27-38. https://doi.org/10.1016/S0140-6736(20)31182-X

Kaufmann KB, Heinrich S, Staehle HF, Bogatyreva L, Buerkle H, Goebel U. Perioperative cytokine profile during lung surgery predicts patients at risk for postoperative complications-A prospective, clinical study. PLoS One. 2018 Jul 3;13(7):e0199807. https://doi.org/10.1371/journal.pone.0199807

Besnier E, Tuech JJ, Schwarz L. We asked the experts: covid-19 outbreak: is there still a place for scheduled surgery? Reflection from pathophysiological data. World J Surg. 2020;44:1695-8. https://doi.org/10.1007/s00268-020-05501-6

Instituto Nacional de Salud. Coronavirus (covid-19) en Colombia [internet]. 2020-2023 [citado 2023 ene 10]. Disponible en: https://www.ins.gov.co/Noticias/Paginas/Coronaviruss.aspx

Instituto Nacional de Salud. Estudio nacional de seroprevalencia de SARS-CoV-2 [internet]. [Citado 2022 dic 12]. Disponible en: https://www.ins.gov.co/estudio-nacional-de-seroprevalencia/reporte.html

Mercado M, Malagón J, Rodríguez I, Zapata S, Wiesner M, Cucunubá Z, et al. Seroprevalence of anti-SARS-CoV-2 antibodies in Colombia, 2020: a population-based study. Lancet Reg Health Am. 2022 May;9:100195.

Saavedra Trujillo CH, et al. Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/covid-19 en establecimientos de atención de la salud. Infectio. 2020;24(3 supl 1):88-100. https://doi.org/10.22354/in.v24i3.851

Prachand VN, Milner R, Angelos P, Posner MC, Fung JJ, Agrawal N, et al. Medically necessary, time-sensitive procedures: scoring system to ethically and efficiently manage resource scarcity and provider risk during the covid-19 pandemic. J Am Coll Surg. 2020 Aug;231(2):281-288. https://doi.org/10.1016/j.jamcollsurg.2020.04.011

Torregrosa L, Prieto RG, Cabrera LF, Ordóñez J, Sánchez E, Rodríguez C, et al. Recomendaciones generales para los servicios de cirugía en Colombia durante la pandemia covid-19 (SARS-CoV-2). Rev Colomb Cirug. 2020;35(2):265-81. https://doi.org/10.30944/20117582.633

Di Martino M, García J, Maqueda R, Muñoz JL, de la Hoz A, Correo A, Martín E. Cirugía electiva durante la pandemia por SARS-CoV-2 (covid-19): análisis de morbimortalidad y recomendaciones sobre priorización de los pacientes y medidas de seguridad. Cir Esp. 2020;98(9):525-32. https://doi.org/10.1016/j.ciresp.2020.04.029

Prasad NK, Lake R, Englum BR, Turner DJ, Siddiqui T, Mayorga-Carlin M, et al. Increased complications in patients who test covid-19 positive after elective surgery and implications for pre and postoperative screening. Am J Surg. 2022 Feb;223(2):380-7. https://doi.org/10.1016/j.amjsurg.2021.04.005

Mohammadzadeh N, Abkhoo A, Ashouri M, Jalaeefar A, Kazemzadeh Houjaghan A, Ghorbani B, et al. Postoperative nosocomial covid-19 infection in surgical patients during pandemic: a prospective observational cohort study. Ann Med Surg (Lond). 2022 Nov;83:104730. https://doi.org/10.1016/j.amsu.2022.104730

Asociación Colombiana de Infectología, Saavedra CH, et al. Prevención y control de la infección por SARS-CoV-2/covid-19. Seccion X. Infectio. 2021;25(4):350. https://doi.org/10.22354/in.v25i4.980

Smith BB, Bosch W, O'Horo JC, Girardo ME, Bolton PB, Murray AW, et al. Surgical site infections during the covid-19 era: a retrospective, multicenter analysis. Am J Infect Control. 2022 Sep 23:S0196-6553(22)00706-4.

Losurdo P, Paiano L, Samardzic N, Germani P, Bernardi L, Borelli M, et al. Impact of lockdown for SARS-CoV-2 (covid-19) on surgical site infection rates: a monocentric observational cohort study. Updates Surg. 2020 Dec;72(4):1263-71. https://doi.org/10.1007/s13304-020-00884-6

Knisely A, Zhou ZN, Wu J, Huang Y, Holcomb K, Melamed A, et al. Perioperative morbidity and mortality of patients with covid-19 who undergo urgent and emergent surgical procedures. Ann Surg. 2021 Jan 1;273(1):34-40. https://doi.org/10.1097/SLA.0000000000004420

American College of Surgeons. Local resumption of elective surgery guidance [internet]. ACS. 2020 [citado 2023 feb 17]. Disponible en: https://www.facs.org/for-medical-professionals/covid-19/clinical-guidance/resuming-elective-surgery/

Inzunza M, Romero C, Irarrázaval MJ, Ruiz-Esquide M, Achurra P, Quezada N, et al. Morbidity and mortality in patients with perioperative covid-19 infection: prospective cohort in general, gastroesophagic, hepatobiliary, and colorectal surgery. World J Surg. 2021 Jun;45(6):1652-62. https://doi.org/10.1007/s00268-021-06068-6

Jonker PKC, van der Plas WY, Steinkamp PJ, Poelstra R, Emous M, van der Meij W, et al.; Dutch Surgical covid-19 Research Collaborative. Perioperative SARS-CoV-2 infections increase mortality, pulmonary complications, and thromboembolic events: a Dutch, multicenter, matched-cohort clinical study. Surgery. 2021 Feb;169(2):264-74. https://doi.org/10.1016/j.surg.2020.09.022

Aminian A, Safari S, Razeghian-Jahromi A, Ghorbani M, Delaney CP. covid-19 outbreak and surgical practice: unexpected fatality in perioperative period. Ann Surg. 2020 Jul;272(1):e27-e29. https://doi.org/10.1097/SLA.0000000000003925

Lei S, Jiang F, Su W, Chen C, Chen J, Mei W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of covid-19 infection. EClinicalMedicine. 2020 Apr 5;21:100331. https://doi.org/10.1016/j.eclinm.2020.100331

Doglietto F, Vezzoli M, Gheza F, Lussardi GL, Domenicucci M, Vecchiarelli L, et al. Factors associated with surgical mortality and complications among patients with and without coronavirus disease 2019 (covid-19) in Italy. JAMA Surg. 2020 Aug 1;155(8):691-702. https://doi.org/10.1001/jamasurg.2020.2713

Nahshon C, Bitterman A, Haddad R, Hazzan D, Lavie O. Hazardous postoperative outcomes of unexpected covid-19 infected patients: a call for global consideration of sampling all asymptomatic patients before surgical treatment. World J Surg. 2020 Aug;44(8):2477-81. https://doi.org/10.1007/s00268-020-05575-2

Prasad NK, Lake R, Englum BR, Turner DJ, Siddiqui T, Mayorga-Carlin M, et al. covid-19 vaccination associated with reduced postoperative SARS-CoV-2 infection and morbidity. Ann Surg. 2022 Jan 1;275(1):31-6. https://doi.org/10.1097/SLA.0000000000005176

Prasad NK, Englum BR, Mayorga-Carlin M, Turner DJ, Sahoo S, Sorkin JD, Lal BK. Partial covid-19 vaccination associated with reduction in postoperative mortality and SARS-CoV-2 infection. Am J Surg. 2022 Oct;224(4):1097-102. https://doi.org/10.1016/j.amjsurg.2022.03.038

Le ST, Kipnis P, Cohn B, Liu VX. covid-19 vaccination and the timing of surgery following covid-19 infection. Ann Surg. 2022 Nov 1;276(5):e265-e272. https://doi.org/10.1097/SLA.0000000000005597

Ciarleglio FA, Rigoni M, Mereu L, Tommaso C, Carrara A, Malossini G, et al. The negative effects of covid-19 and national lockdown on emergency surgery morbidity due to delayed access. World J Emerg Surg. 2021 Jul 13;16(1):37. https://doi.org/10.1186/s13017-021-00382-z

COVIDSurg Collaborative. Effect of covid-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study. Lancet Oncol. 2021 Nov;22(11):1507-17. https://doi.org/10.1016/S1470-2045(21)00493-9

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Copyright (c) 2024 Sandra Liliana Valderrama Beltrán , Reinaldo Grueso Angulo , Juan Sebastian Montealegre Diaz, Marcela Bernal Gutiérrez, Juan Guillermo Cataño Cataño, Silvia Helena Galvis Navarrete, Edgar Arturo Ramirez Schneider, Maria Paula Torres Ortiz, Esteban Portilla Rojas, Lilian Torregrosa Almonacid