Département d'Anesthésie Réanimation, Sorbonne Université, GRC 29, AP-HP, DMU DREAM, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Site Pitié-Salpêtrière, 75013, Paris, France.
Department of Anesthesia and Intensive Care Unit, Regional University Hospital of Montpellier, St-Eloi Hospital, University of Montpellier, PhyMedExp, INSERM U1046, CNRS UMR, 9214CEDEX 5, Montpellier, France.
BMC Anesthesiol. 2022 Feb 14;22(1):46. doi: 10.1186/s12871-022-01581-0.
There are limited data to detail the perioperative anesthetic management and the incidence of postoperative respiratory complications among patients requiring an anesthetic procedure while being SARS-CoV-2 positive or suspected.
An observational multicenter cohort study was performed including consecutive patients who were SARS-CoV-2 confirmed or suspected and who underwent scheduled and emergency anesthesia between March 17 and May 26, 2020.
A total of 187 patients underwent anesthesia with SARS-CoV-2 confirmed or suspected, with ultimately 135 (72.2%) patients positive and 52 (27.8%) negative. The median SOFA score was 2 [0; 5], and the median ARISCAT score was 49 [36; 67]. The major respiratory complications rate was 48.7% (n = 91) with 40.4% (n = 21) and 51.9% (n = 70) in the SARS-CoV-2-negative and -positive groups, respectively (p = 0.21). Among both positive and negative groups, patients with a high ARISCAT risk score (> 44) had a higher risk of presenting major respiratory complications (p < 0.01 and p = 0.1, respectively).
When comparing SARS-COV-2-positive and -negative patients, no significant difference was found regarding the rate of postoperative complications, while baseline characteristics strongly impact these outcomes. This finding suggests that patients should be scheduled for anesthetic procedures based on their overall risk of postoperative complication, and not just based on their SARS-CoV-2 status.
关于需要麻醉的 SARS-CoV-2 阳性或疑似患者的围手术期麻醉管理和术后呼吸并发症发生率,目前仅有有限的数据可供参考。
这是一项观察性多中心队列研究,纳入了 2020 年 3 月 17 日至 5 月 26 日期间接受择期和急诊麻醉且 SARS-CoV-2 确诊或疑似的连续患者。
共 187 例患者接受了 SARS-CoV-2 确诊或疑似患者的麻醉,最终有 135 例(72.2%)患者阳性,52 例(27.8%)患者阴性。SOFA 评分中位数为 2 [0;5],ARISCAT 评分中位数为 49 [36;67]。主要呼吸系统并发症发生率为 48.7%(n=91),其中 SARS-CoV-2 阴性组和阳性组分别为 40.4%(n=21)和 51.9%(n=70)(p=0.21)。在阳性和阴性两组中,ARISCAT 风险评分较高(>44)的患者发生主要呼吸系统并发症的风险更高(p<0.01 和 p=0.1,分别)。
当比较 SARS-CoV-2 阳性和阴性患者时,术后并发症发生率没有显著差异,而基线特征对这些结果有重要影响。这一发现表明,应根据患者术后并发症的总体风险而不是仅根据其 SARS-CoV-2 状态来安排麻醉程序。