神经外科中感染新型冠状病毒2的患者围手术期并发症
Perioperative Complications of Patients with SARS-CoV-2 Infection in Neurosurgery.
作者信息
Greuter Ladina, Zweifel Christian, Guzman Raphael, Soleman Jehuda
机构信息
Department of Neurosurgery, University Hospital of Basel, 4031 Basel, Switzerland.
Department of Neurosurgery, Cantonal Hospital Graubünden, 7000 Chur, Switzerland.
出版信息
J Clin Med. 2022 Jan 27;11(3):657. doi: 10.3390/jcm11030657.
BACKGROUND
The outbreak of coronavirus disease 2019 (COVID-19) has been rapidly evolving, resulting in a pandemic, with 270,031,622 infections according to the World Health Organization. Patients suffering from COVID-19 have also been described to suffer from neurologic and coagulopathic symptoms apart from the better-known flu-like symptoms. Some studies showed that patients suffering from COVID-19 were likely to developed intracranial hemorrhages. To our knowledge, only a few studies have investigated postoperative complications in COVID-19-positive neurosurgical patients and investigated the perioperative complications, either thrombotic or hemorrhagic, in patients with SARS-CoV-2 undergoing a neurosurgical intervention.
METHODS
We conducted a retrospective cohort study including patients from March 2020 to March 2021 undergoing neurosurgical interventions and suffering from COVID-19. Our primary outcome parameter was a hemorrhagic or thrombotic complication within 30 days after surgery. These outcomes were compared to those for a COVID-19-negative cohort of patients using propensity score matching.
RESULTS
We included ten COVID-19-positive patients with a mean age of 56.00 (±14.91) years. Twelve postoperative complications occurred in five patients. Three thrombotic complications (30%) were observed, with two cerebral sinus vein thromboses and one pulmonary embolus. Two patients suffered from a postoperative hemorrhagic complication (20%). The mean postoperative GCS was 14.30 (±1.57). COVID-19-positive patients showed a significantly higher rate of overall postoperative complications ((6 (60.0%) vs. 10 (19.2%), = 0.021), thrombotic complications (3 (30.0%) vs. 1 (1.9%), = 0.009), and mortality (2 (20.0%) vs. 0 (0.0%), = 0.021) compared to the matched cohort of COVID-19-negative patients, treated at our institute before the SARS-CoV-2 pandemic.
CONCLUSION
Patients undergoing neurosurgical operations with concomitant COVID-19 infection have higher rates of perioperative complications.
背景
2019年冠状病毒病（COVID-19）疫情迅速演变，导致全球大流行，据世界卫生组织统计，感染人数达270,031,622例。除了众所周知的流感样症状外，COVID-19患者还出现了神经和凝血方面的症状。一些研究表明，COVID-19患者可能会发生颅内出血。据我们所知，只有少数研究调查了COVID-19阳性神经外科患者的术后并发症，以及接受神经外科手术的SARS-CoV-2患者围手术期的血栓形成或出血等并发症。
方法
我们进行了一项回顾性队列研究，纳入了2020年3月至2021年3月期间接受神经外科手术且患有COVID-19的患者。我们的主要结局参数是术后30天内的出血或血栓形成并发症。使用倾向评分匹配法将这些结局与COVID-19阴性患者队列的结局进行比较。
结果
我们纳入了10例COVID-19阳性患者，平均年龄为56.00（±14.91）岁。5例患者出现了12例术后并发症。观察到3例血栓形成并发症（30%），其中2例为脑静脉窦血栓形成，1例为肺栓塞。2例患者出现术后出血并发症（20%）。术后平均格拉斯哥昏迷评分（GCS）为14.30（±1.57）。与我们研究所SARS-CoV-2大流行之前治疗的匹配COVID-19阴性患者队列相比，COVID-19阳性患者的总体术后并发症发生率（6例（60.0%）对10例（19.2%），P = 0.021）、血栓形成并发症发生率（3例（30.0%）对1例（1.9%），P = 0.009）和死亡率（2例（20.0%）对0例（0.0%），P = 0.021）显著更高。
结论
合并COVID-19感染接受神经外科手术的患者围手术期并发症发生率更高。
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