Departments of Anesthesiology.
Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY.
J Neurosurg Anesthesiol. 2022 Jan 1;34(1):132-135. doi: 10.1097/ANA.0000000000000805.
New York State implemented an 11-week elective surgery ban in response to the coronavirus disease-2019 (COVID-19) pandemic, during which pediatric patients from the 10 New York Presbyterian network hospitals requiring urgent or emergent surgical procedures were cared for at Morgan Stanley Children's Hospital (MSCH).
Data was abstracted from the electronic medical record of all patients aged 0 to 20 years who had surgery at MSCH from March 23, 2020 to June 7, 2020. Comparative analysis of demographic and clinical data elements between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive and negative cohorts was conducted using the Fisher exact tests.
A total of 505 surgical procedures were performed in 451 patients, with 32 procedures (6.3%) performed in 21 SARS-CoV-2-positive children. The prevalence of SARS-CoV-2 positivity in Medicaid beneficiaries was more than twice the prevalence in commercially insured (6.8% vs. 2.6%, P=0.04) children. SARS-CoV-2-positive patients were more likely to undergo multiple surgical procedures (23.8% vs. 7.2%, P=0.02), and to have higher American Society of Anesthesiologists (ASA) class designations (69.8% III to V vs. 47.4% I to II, P=0.03). There was no significant difference in the prevalence of SARS-CoV-2 positivity across sex, age, race, or ethnicity groups, or in emergent case status or surgical procedure type. Thirty-day mortality rate was <0.1% overall, with no deaths in the SARS-CoV-2-positive group.
During the first wave of the COVID-19 pandemic in New York City, we found a higher prevalence of SARS-CoV-2 positivity in urgent/emergent pediatric surgical patients compared with other institutions in the United States. SARS-CoV-2-positive patients were more likely to be Medicaid beneficiaries, were clinically more complex, and had more surgical procedures.
纽约州实施了一项为期 11 周的选择性手术禁令，以应对 2019 年冠状病毒病（COVID-19）大流行，在此期间，来自 10 家纽约长老会网络医院的需要紧急或紧急手术的儿科患者在摩根士丹利儿童医院（MSCH）接受治疗。
从 2020 年 3 月 23 日至 2020 年 6 月 7 日在 MSCH 接受手术的所有 0 至 20 岁患者的电子病历中提取数据。使用 Fisher 精确检验对 SARS-CoV-2 阳性和阴性队列的人口统计学和临床数据元素进行比较分析。
共进行了 505 例手术，涉及 451 例患者，其中 21 例 SARS-CoV-2 阳性儿童进行了 32 例手术（6.3%）。医疗补助受益人的 SARS-CoV-2 阳性率是商业保险受益人的两倍多（6.8%对 2.6%，P=0.04）。SARS-CoV-2 阳性患者更有可能接受多次手术（23.8%对 7.2%，P=0.02），并且具有更高的美国麻醉医师协会（ASA）分级（69.8%III 至 V 对 47.4%I 至 II，P=0.03）。在性别、年龄、种族或族裔群体、紧急情况或手术类型方面，SARS-CoV-2 阳性率无显著差异。总体 30 天死亡率<0.1%，SARS-CoV-2 阳性组无死亡病例。
在纽约市 COVID-19 大流行的第一波中，我们发现与美国其他机构相比，紧急/紧急儿科手术患者中 SARS-CoV-2 阳性率更高。SARS-CoV-2 阳性患者更有可能是医疗补助受益人，病情更复杂，手术更多。
