Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, New York.
Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, New York.
J Surg Res. 2021 May;261:113-122. doi: 10.1016/j.jss.2020.10.032. Epub 2020 Nov 23.
The coronavirus disease 2019 (COVID-19) global pandemic has led to a halt in elective surgeries throughout the United States and many other countries throughout the world. Early reports suggest that COVID-19 patients undergoing surgery have an increased risk of requiring intensive care unit (ICU) admission and overall mortality.
A retrospective review was performed of all COVID-19, positive with polymerase chain reaction confirmation, patients who had surgery between February 17, 2020 and April 26, 2020 at a major New York City hospital. Clinical characteristics and outcomes including ICU admission, ventilator requirement, and mortality were analyzed.
Thirty-nine COVID-19 surgical patients were identified. Mean age was 53.9 y, and there were more men than women in the cohort (56.4% versus 43.6%). Twenty-two patients (56.4%) had a confirmed positive COVID-19 test preoperatively, and the remainder tested positive after their procedure. The majority (59%) of patients had an American Society of Anesthesiologists (ASA) class of 3 or higher. Postoperatively, 7 patients (17.9%) required ICU level care with a mean length of stay of 7.7 d. There were 4 deaths (10.3%) in this patient population, all of which occurred in patients who were ASA class 3 or 4.
This study represents the largest study to date, that objectively analyzes the outcomes of COVID-19 positive patients who underwent surgery. Overall, ICU admission rates and mortality are similar to reported rates in the literature for nonsurgical COVID-19 patients. Notably, in COVID-19 patients with ASA 1 or 2, there was a 0% mortality rate in the postoperative period.
2019 年冠状病毒病（COVID-19）全球大流行导致美国和世界许多其他国家的择期手术全部停止。早期报告表明，接受手术的 COVID-19 患者有更高的入住重症监护病房（ICU）和总体死亡率的风险。
对 2020 年 2 月 17 日至 2020 年 4 月 26 日在纽约市一家主要医院接受手术的所有经聚合酶链反应确认的 COVID-19 阳性患者进行了回顾性审查。分析了临床特征和结果，包括 ICU 入院、呼吸机需求和死亡率。
确定了 39 例 COVID-19 手术患者。平均年龄为 53.9 岁，队列中男性多于女性（56.4%比 43.6%）。22 例（56.4%）术前有确诊的 COVID-19 阳性检测，其余患者在手术后检测呈阳性。大多数（59%）患者的美国麻醉师协会（ASA）分级为 3 级或更高。术后，7 例（17.9%）需要 ICU 级护理，平均住院时间为 7.7 天。该患者人群中有 4 例死亡（10.3%），均发生在 ASA 分级为 3 级或 4 级的患者中。
本研究代表了迄今为止对接受手术的 COVID-19 阳性患者进行的结果进行客观分析的最大研究。总体而言，ICU 入住率和死亡率与文献中报告的非手术 COVID-19 患者的比率相似。值得注意的是，在 COVID-19 患者中，ASA 1 或 2 的患者在术后期间死亡率为 0%。
