Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sapienza University of Rome, Via di Grottarossa 1035 00189, Rome, Italy.
Thoracic Surgery, Department of Clinical and Surgical Translational Medicine, Sapienza University of Rome, Via di Grottarossa 1035 00189, Rome, Italy.
Int J Clin Pract. 2023 Mar 4;2023:8993295. doi: 10.1155/2023/8993295. eCollection 2023.
During coronavirus disease (COVID-19) pandemic, preoperative screening before thoracic surgery is paramount in order to protect patients and staff from undetected infections. This study aimed to determine which preoperative COVID-19 screening tool was the most effective strategy before thoracic surgery.
This retrospective cohort multicenter study was performed at 3 Italian thoracic surgery centers. All adult patients scheduled for thoracic surgery procedures from 4th March until 24th April, 2020, and submitted to COVID-19 preoperative screenings were included. The primary outcome was the yield of screening of the different strategies.
A total of 430 screenings were performed on 275 patients; 275 anamnestic questionnaires were administered. 77 patients were screened by an anamnestic questionnaire and reverse transcriptase polymerase chain reaction (RT-PCR). 78 patients were selected to combine screening with anamnestic questionnaire and chest computed tomography (CT). The positive yield of screening using a combination of anamnestic questionnaire and RT-PCR was 7.8% (95% CI: 2.6-14.3), while using a combination of anamnestic questionnaire and chest CT was 3.8% (95% CI: 0-9). Individual yields were 1.1% (95% CI: 0-2.5) for anamnestic questionnaire, 5.2% (95% CI: 1.3-11.7) for RT-PCR, and 3.8% (95% CI: 0-9).
The association of anamnestic questionnaire and RT-PCR is able to detect around 8 positives in 100 asymptomatic patients. This combined strategy could be a valuable preoperative SARS-CoV-2 screening tool before thoracic surgery.
在冠状病毒病（COVID-19）大流行期间，胸部手术前的术前筛查对于保护患者和工作人员免受未被发现的感染至关重要。本研究旨在确定在胸部手术前哪种术前 COVID-19 筛查工具是最有效的策略。
这是一项在意大利 3 个胸外科中心进行的回顾性队列多中心研究。所有于 2020 年 3 月 4 日至 4 月 24 日接受胸外科手术的成年患者，以及接受 COVID-19 术前筛查的患者均被纳入研究。主要结局是不同策略筛查的检出率。
共对 275 例患者进行了 430 次筛查；进行了 275 次病历问卷调查。对 77 例患者进行了病历问卷和逆转录聚合酶链反应（RT-PCR）筛查。对 78 例患者进行了病历问卷和胸部计算机断层扫描（CT）相结合的筛查。使用病历问卷和 RT-PCR 联合筛查的阳性检出率为 7.8%（95%CI：2.6-14.3），而使用病历问卷和胸部 CT 联合筛查的阳性检出率为 3.8%（95%CI：0-9）。单独使用病历问卷、RT-PCR 和胸部 CT 的检出率分别为 1.1%（95%CI：0-2.5）、5.2%（95%CI：1.3-11.7）和 3.8%（95%CI：0-9）。
病历问卷和 RT-PCR 的联合使用能够在 100 名无症状患者中检出约 8 例阳性。这种联合策略可能是胸部手术前 SARS-CoV-2 筛查的一种有价值的工具。
