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急诊剖腹手术与围手术期新冠病毒肺炎:一项单中心回顾性队列研究

Emergency laparotomy and perioperative COVID-19: a single-center retrospective cohort study.

作者信息

Mohammadi Tofigh Arash, Hasanzade Arman, Haghbin Toutounchi Alireza, Khoshnoudi Hojatolah, Aghaei Mohammad

机构信息

Department of General Surgery, Imam Hossein Medical and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Updates Surg. 2024 Apr;76(2):699-703. doi: 10.1007/s13304-023-01730-1. Epub 2023 Dec 26.

Abstract

Concerning the perioperative outcomes of patients diagnosed with COVID-19 who underwent emergency laparotomy, more data must be collected. Because COVID-19 can affect multiple organs, cause various complications, and act as a risk factor for surgery, in this study, we aimed to compare the outcomes of emergency laparotomy between SARS-CoV-2 infected and uninfected patients. This retrospective cohort study was conducted on patients who underwent emergency laparotomy from December 2021 to December 2022. Postoperative outcomes were compared between patients with and without confirmed perioperative SARS-CoV-2 infection. The primary outcome was 30-day mortality. Secondary outcomes were postoperative intensive care unit admission, hospital length of stay, re-operation, and postoperative complications. Data were analyzed by SPSS statistic version 27. In this study, 50 patients in the COVID-19 group and 91 patients in the non-COVID-19 group were assessed. The 30-day mortality in the COVID-19 group was significantly higher than in the non-COVID-19 group (34% vs. 12.1%, respectively, P = 0.004). Postoperative complications were significantly higher in the COVID-19 group (64% vs. 26.4%, P < 0.001). The frequency of ICU admission and need for re-operation were significantly higher in the COVID-19 group (P = 0.003 and P = 0.039, respectively). Length of hospital stay was significantly lower in the non-COVID-19 group (P = 0.021). In patients with confirmed COVID-19, emergency laparotomy is associated with increased postoperative morbidity and mortality. Additionally, emergency laparotomy is associated with increasing postoperative complications, length of hospital stay, intensive care admission, and additional surgery requirement.

摘要

关于接受急诊剖腹手术的新冠肺炎确诊患者的围手术期结局,必须收集更多数据。由于新冠肺炎可影响多个器官、引发各种并发症并成为手术的危险因素,在本研究中,我们旨在比较感染和未感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的患者进行急诊剖腹手术的结局。本回顾性队列研究针对2021年12月至2022年12月期间接受急诊剖腹手术的患者开展。比较了围手术期确诊SARS-CoV-2感染和未感染患者的术后结局。主要结局是30天死亡率。次要结局包括术后重症监护病房入住情况、住院时间、再次手术以及术后并发症。数据采用SPSS统计软件27版进行分析。本研究评估了新冠肺炎组的50例患者和非新冠肺炎组的91例患者。新冠肺炎组的30天死亡率显著高于非新冠肺炎组(分别为34%和12.1%,P = 0.004)。新冠肺炎组的术后并发症显著更多(64%对26.4%,P < 0.001)。新冠肺炎组的重症监护病房入住频率和再次手术需求显著更高(分别为P = 0.003和P = 0.039)。非新冠肺炎组的住院时间显著更短(P = 0.021)。在确诊新冠肺炎的患者中,急诊剖腹手术与术后发病率和死亡率增加相关。此外,急诊剖腹手术还与术后并发症增加、住院时间延长、重症监护入住以及额外的手术需求相关。

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