Surgical Outcomes During COVID-19 Pandemic

Nachón-Acosta, Andrea; Martínez-Mier, Gustavo; Flores-Gamboa, Victor; Avila-Mercado, O.; García, I. M.; Yoldi-Aguirre, C.A.; Olivares-Garcia, Irais; Paz-Román, Maritza De la

doi:10.1016/j.arcmed.2021.01.003

Cited by 13 publications

(8 citation statements)

References 22 publications

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“…To the best of our knowledge, this is the largest observational cohort study including COVID-19–positive patients from a variety of surgical specialties. We found the postoperative 30-day mortality rate to be 4.01%, which was lower than the previous studies reporting mortality rates ranging from 14.7% to 27.3% 4–12. We believe that this difference can be explained by the differences in the study periods, as well as better understanding of the care of patients with COVID-19 and development of perioperative management protocols over time.…”

Section: Discussioncontrasting

confidence: 67%

“…We found the postoperative 30-day mortality rate to be 4.01%, which was lower than the previous studies reporting mortality rates ranging from 14.7% to 27.3%. [4][5][6][7][8][9][10][11][12] We believe that this difference can be explained by the differences in the study periods, as well as better understanding of the care of patients with COVID-19 and development of perioperative management protocols over time. As our study included patients who had interventions in the height of the pandemic (January 2020 to March 2021), we were able to include a possibly larger proportion of patients who were vaccinated and as a result had asymptomatic/milder disease.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors Associated With Postoperative Mortality Among COVID-19 Positive Patients: Results of 3027 Operations and Procedures

Yılmaz¹,

Sapcı²,

Jia

et al. 2022

Annals of Surgery

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Objective: To investigate the predictors of postoperative mortality in coronavirus disease 2019 (COVID-19)-positive patients. Background: COVID-19-positive patients have more postoperative complications. Studies investigating the risk factors for postoperative mortality in COVID-19-positive patients are limited. Methods: COVID-19-positive patients who underwent surgeries/procedures in Cleveland Clinic between January 2020 and March 2021 were identified retrospectively. The primary outcome was postoperative/procedural 30-day mortality. Secondary outcomes were length of stay, intensive care unit admission, and 30-day readmission. Results: A total of 2543 patients who underwent 3027 surgeries/procedures were included. Total 48.5% of the patients were male. The mean age was 57.8 (18.3) years. A total of 71.2% had at least 1 comorbidity. Total 78.7% of the cases were elective. The median operative time was 94 (47.0-162) minutes and mean length of stay was 6.43 (13.4) days. Postoperative/procedural mortality rate was 4.01%. Increased age [odds ratio (OR): 1.66, 95% CI, 1.4-1.98; P < 0.001], being a current smoker [2.76, (1.3-5.82); P = 0.008], presence of comorbidity [3.22, (1.03-10.03); P = 0.043], emergency [6.35, (3.39-11.89); P < 0.001] and urgent versus [1.78, (1.12-2.84); P = 0.015] elective surgery, admission through the emergency department [15.97, (2.00-127.31); P = 0.009], or inpatient service [32.28, (7.75-134.46); P < 0.001] versus outpatients were associated with mortality in the multivariable analysis. Among all specialties, thoracic surgery [3.76, (1.66-8.53); P = 0.002] had the highest association with mortality. Total 17.5% of the patients required intensive care unit admission with increased body mass index being a predictor [1.03, (1.01-1.05); P = 0.005]. Conclusions: COVID-19-positive patients have higher risk of postintervention mortality. Risk factors should be carefully evaluated before intervention. Further studies are needed to understand the impact of pandemic on long-term surgical/procedural outcomes.

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Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated With Postoperative Mortality Among COVID-19 Positive Patients: Results of 3027 Operations and Procedures

Yılmaz¹,

Sapcı²,

Jia

et al. 2022

Annals of Surgery

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“…The survey results suggest that the morbidity and mortality of HPB surgery raised during 2020 (around 20%) was attributable to COVID-19 infection and directly related COVID-19 causes, such as lack of hospital areas and resources as well. It is well known that COVID-19 infection increases surgical morbidity and mortality [6][7][8] . Nevertheless, some initial experiences on HPB procedures did not describe augmented morbidity and mortality [9][10][11] ; although they are small single-center series, which permits to think that the smaller number of procedures performed, less morbidity and mortality will occur (one of the answers in our survey about why morbidity and mortality on HPB procedures did not change according to the respondents).…”

Section: Discussionmentioning

confidence: 99%

“…They are particularly susceptible to pulmonary complications, due to proinflammatory cytokines, immunosuppressive response to surgery, and mechanical ventilation. Morbidity and mortality in COVID-19 patients are higher than patients without COVID-19 [6][7][8] .…”

Section: Introductionmentioning

confidence: 91%

La cirugía hepato-pancreato-biliar en México y America Latina durante la pandemia COVID-19 (2020): Resultados de una encuesta de la AMHPB

Martínez-Mier¹,

Melchor‐Ruan²,

Beristain-Hernández³

et al. 2022

CIRU

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Background:The Mexican Hepato-Pancreato-Biliary Association (AMHPB) conducted a survey, aiming to gather experience and opinions of HPB surgeons about HPB surgery in the 2020 COVID-19 pandemic year. Methods: An online survey was conducted (33 items: demographics, patient referral, COVID-19 screening and limitations, hospital occupancy and surgical practice) to AMHPB members and attendees of the previous meetings of the Society through a self-administered questionnaire. Answers were excluded if respondents were not from Latin America. Results: 88 participants answered (47.5 ± 10 years, 94% male and 65.9% Mexicans). About 8% worked in COVID-19 converted hospitals. About 1.1% did not perform pre-operative COVID-19 testing. Polymerase chain reaction (33%) was the most common COVID-19 pre-operative test. The number of patient referrals decreased 62.5%. About 29.5% had one patient who died from COVID-19 during preoperative surgical evaluation. About 64.7% answered that surgical case volume decreased. About 17% and 23% respondents considered that surgical morbidity and mortality increased, respectively. Hospital resources and COVID-19 infection were responsible for change in surgical outcomes. Lack of ICU beds (54%) was the most common cause of surgical cancellation. Conclusion: COVID-19 had a strong negative impact on HPB surgery in Mexico and Latin America in terms of patient reference, case volume and surgical outcomes.

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“…The most important recommendation commonly included in all the guidelines concerning colorectal cancer was to avoid surgery in COVID-19-positive patients. Other recommendations included immediate surgery in emergency cases, such as obstruction and perforation; postponement of elective cases; and preference of non-surgical treatments in stage II/III rectal and metastatic colorectal cancer [3,4,7].…”

Section: Introductionmentioning

confidence: 99%

Effects of the COVID-19 pandemic on colorectal cancer surgery

Hasırcı

Ulutaş²,

Özden

et al. 2023

J Surg Med

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Background/Aim: In accordance with the guidelines published during the COVID-19 pandemic, cancer operations, except for emergencies, were postponed. However, the effect of postponed surgical treatment on the outcomes of cancer cases has not yet been determined. Therefore, this study aimed to compare the clinical data and outcomes of patients who underwent surgery for colorectal cancer before and during the pandemic. Methods: This retrospective cohort study was conducted in the Department of General Surgery. Patients who underwent surgery for colorectal cancer during the pre-pandemic period (February 1, 2019-December 31, 2019) and pandemic period (August 1, 2020-June 30, 2021) were included. The patients’ demographic data, clinical and laboratory findings, clinical presentation, operation type, complications, and pathology results were retrospectively obtained by screening the patient files. Results: The study included a total of 183 patients, 91 in the pre-pandemic period and 92 in the pandemic period. During the pandemic period, the length of hospital stay was significantly shorter, but the rate of readmission after discharge was significantly higher (P<0.001, P=0.04). There was no significant difference between the two periods in terms of disease stage. During the pandemic period, the number of cases that underwent emergency surgery was significantly higher. The rates of mortality and postoperative complication rates were also significantly higher (P=0.04, P<0.001). Conclusion: The pandemic had serious effects on colorectal cancer cases. There was an increase in mortality and morbidity due to the increase in complicated cases.

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Surgical Outcomes During COVID-19 Pandemic

Cited by 13 publications

References 22 publications

Risk Factors Associated With Postoperative Mortality Among COVID-19 Positive Patients: Results of 3027 Operations and Procedures

Risk Factors Associated With Postoperative Mortality Among COVID-19 Positive Patients: Results of 3027 Operations and Procedures

La cirugía hepato-pancreato-biliar en México y America Latina durante la pandemia COVID-19 (2020): Resultados de una encuesta de la AMHPB

Effects of the COVID-19 pandemic on colorectal cancer surgery

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