Postoperative In-Hospital Morbidity and Mortality of Patients With COVID-19 Infection Compared With Patients Without COVID-19 Infection

Haffner, Max R.; Le, Hai; Saiz, Augustine M.; Han, Gloria; Fine, Jeffrey; Wolinsky, Philip R; Klineberg, Eric O.

doi:10.1001/jamanetworkopen.2021.5697

Cited by 36 publications

(42 citation statements)

References 7 publications

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“…Comparison of outcomes between acyanotic and cyanotic lesions was also performed. Demographics, LOS, rate of the presence of complications listed in the Vizient Clinical Data Base [ 6 ], in-hospital mortality, and total hospital costs were collected. To determine if there was a difference in admission severity of illness or mortality risk between the groups, queries were preformed from Vizient-defined “Acuity Scale Mortality” (severity of illness at admission) and “Relative Expected Mortality” (mortality risk at admission).…”

Section: Methodsmentioning

confidence: 99%

Worse Hospital Outcomes for Children and Adults with COVID-19 and Congenital Heart Disease

et al. 2021

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The aim of the current study is to investigate hospitalization outcomes of COVID-19 positive children and adults with moderate or severe congenital heart disease to children and adults without congenital heart disease. Retrospective review using the Vizient Clinical Data Base for admissions of patients with an ICD-10 code for COVID-19 from April 2020 to March 2021. Admissions with COVID-19 and with and without moderate or severe congenital heart disease (CHD) were stratified into pediatric (< 18 years) and adult (≥ 18 years) and hospital outcomes were compared. There were 9478 pediatric COVID-19 admissions, 160 (1.7%) with CHD, and 658,230 adult COVID-19 admissions, 389 (0.06%) with CHD. Pediatric admissions with COVID-19 and CHD were younger (1 vs 11 years), had longer length of stay (22 vs 6 days), higher complication rates (6.9 vs 1.1%), higher mortality rates (3.8, 0.8%), and higher costs ($54,619 vs 10,731; p < 0.001 for all). Adult admissions with COVID-19 and CHD were younger (53 vs 64 years, p < 0.001), had longer length of stay (12 vs 9 days, p < 0.001), higher complication rates (8 vs 4.8%, p = 0.003), and higher costs ($23,551 vs 13,311, p < 0.001). This appears to be the first study to report the increased hospital morbidities and costs for patients with CHD affected by COVID-19. Our hope is that these findings will help counsel patients moving forward during the pandemic.

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Section: Methodsmentioning

confidence: 99%

Worse Hospital Outcomes for Children and Adults with COVID-19 and Congenital Heart Disease

et al. 2021

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“…2,5 Several studies have reported the perioperative outcome of SARS-CoV-2-infected patients. 6,7 A recent study found that surgical mortality was 23.8% in patients infected with COVID-19, and more than half of patients developed postoperative pulmonary complications. 6 In a similar study, mortality in surgical patients was shown to be two times higher in COVID-19-infected patients.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and hematological parameters associated with disease severity in COVID‐19 positive pregnant women undergoing cesarean section: A single‐center experience

Bora

Bicer

Şahin

et al. 2021

J of Obstet and Gynaecol

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Aim: The study aimed to describe clinical characteristics and outcomes of pregnant women with COVID-19 undergoing cesarean section, and evaluated the association of blood values at admission with severe COVID-19 disease in this group of patients. Method: We retrospectively analyzed the clinical data of 110 patients infected with COVID-19 who underwent cesarean section at Adana City Education and Research Hospital in Turkey. The COVID-19 severity of the patients was classified as either severe or nonsevere disease according to World Health Organization of COVID-19 clinical management guidance. We compared blood values, clinical characteristics, and outcomes between severe and nonsevere patients. Receiver operating characteristics (ROC) curves analyses and area under the ROC curve (AUC) value was calculated to evaluate the predictive value of blood parameters on the COVID-19 severity. Results: Of the 110 women, 12 were severe cases. Severe patients had higher ferritin, neutrophil-tolymphocyte ratio (NLR), lactate dehydrogenase (LDH), alanine transaminase (ALT), aspartate transaminase (AST), and procalcitonin levels on admission (p < 0.05). The ROC analysis demonstrated AUC of NLR, LDH, AST, ALT, ferritin, and procalcitonin was 0.757, 0.856, 0.840, 0.771, 0.821, and 0.698, respectively. The LDH had a maximum specificity (90.8%), with the cutoff value of 365. The O-blood group was more likely to have severe illness than the non-O-blood group (relative risk: 3.6; 95% confidence interval; 1.2-10.4). Conclusion:This study shows that LDH values at admission are an early and powerful predictor of severe infection for pregnant women with COVID-19 who will undergo a cesarean section.

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“…For patients with confirmed COVID-19 requiring surgery, it should be deferred due to the high risk of postoperative complications and nosocomial spread. 9 – 11 , 19 In our institutional protocol, all patients with COVID-19 symptoms (detected from the questionnaire) or with positive RT-PCR test results will have their surgery deferred by the doctor, and a clinical evaluation will be scheduled on the date of deferral. Postoperative infection should be mitigated as early as possible, given the higher risk of mortality during postoperative recovery.…”

Section: Discussionmentioning

confidence: 99%

Oncological Surgery During the COVID-19 Pandemic: Effectiveness of Preoperative Screening and Factors Associated with Postoperative SARS-CoV-2 Infection

et al. 2022

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Background Routine preoperative screening of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with reverse transcriptase-polymerase chain reaction (RT-PCR) may reduce in-hospital SARS-CoV-2 transmission. Methods This was a prospective, observational, cohort study. The endpoints were the incidence of asymptomatic patients with positive preoperative RT-PCR results and the incidence and factors associated with postoperative SARS-CoV-2 infection in patients with cancer referred for elective surgery. Patients with elective surgery between May and October 2020 were included. RT-PCR of nasopharyngeal swabs was performed preoperatively for all patients. Postoperative SARS-CoV-2 infection was assessed within 30 postoperative days. Results A total of 1636 preoperative screening RT-PCR tests were performed. Of these, 102 (6.2%) cases were positive, and 1,298 surgical procedures were analyzed. The postoperative SARS-CoV-2 infection rate was 0.9%. The length of stay (odds ratio [OR] 1.08; 95% confidence interval [CI] 1.04–1.11; p < 0.001), surgical time (OR 1.004; 95% CI 1.001–1.008; p = 0.023), intensive care unit admission (OR 7.7; 95% CI 2.03–29.28; p = 0.003), and hospital readmissions (OR 9.56; 95% CI 2.50–36.56; p = 0.001) were associated with postoperative coronavirus disease (COVID-19). Using unadjusted and adjusted logistic regression, length of stay (OR 1.08; 95% CI 1.04–1.11; p < 0.001), and readmission (OR 9.02; 95% CI 2.30–35.48; p = 0.002) were independent factors of postoperative COVID-19. Conclusions Screening patients preoperatively may reduce in-hospital SARS-CoV-2 transmission. Length of stay and readmission were independently correlated with postoperative COVID-19.

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Postoperative In-Hospital Morbidity and Mortality of Patients With COVID-19 Infection Compared With Patients Without COVID-19 Infection

Abstract: This cohort study uses the Vizient Clinical Data Base to compare the postoperative in-hospital morbidity and mortality of surgical patients with COVID-19 infection with patients without COVID-19 infection.

Cited by 36 publications

References 7 publications

Worse Hospital Outcomes for Children and Adults with COVID-19 and Congenital Heart Disease

Worse Hospital Outcomes for Children and Adults with COVID-19 and Congenital Heart Disease

Clinical characteristics and hematological parameters associated with disease severity in COVID‐19 positive pregnant women undergoing cesarean section: A single‐center experience

Oncological Surgery During the COVID-19 Pandemic: Effectiveness of Preoperative Screening and Factors Associated with Postoperative SARS-CoV-2 Infection

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