Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Am Surg. 2024 Jun;90(6):1224-1233. doi: 10.1177/00031348241227213. Epub 2024 Jan 12.
The COVID-19 pandemic posed significant challenges to healthcare systems worldwide, including surgical care. While many studies examined the effect of the pandemic on different patient outcomes, there are none to date examining the impact of the pandemic surge on surgical outcomes. Our aim is to evaluate the impact of the COVID-19 surges on surgical outcomes using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.
A single-center retrospective analysis of 7436 patients who underwent surgery between February 2020 and December 2022 was conducted. Patients were divided into those who underwent surgery during the surge of the pandemic (n = 1217) or outside that period (n = 6219). Primary outcomes were 30-day mortality and morbidity. Secondary outcomes included 30-day mortality, operation time, transfusion, reoperation, and specific postoperative complications. Multivariable logistic regression was used in our analysis. All analyses were conducted using the software "R" version 4.2.1. Statistical significance was set at α = .05 level.
After adjusting for confounders, we found no significant difference in 30-day mortality and morbidity (OR: 1.06, 95% CI: .89-1.226, = .5173) or 30-day mortality only (OR: 1.39, 95% CI: .788-2.14, = .1364) between the two groups. No significant differences were observed in secondary outcomes. Sensitivity analyses yielded similar results to the multivariable logistic regression.
We found no evidence of increased 30-day mortality and morbidity in patients undergoing surgery during the COVID-19 surges compared to those undergoing surgery outside that period. Our results suggest that surgical care was maintained despite the challenges of the pandemic surges.
COVID-19 大流行对全球医疗保健系统，包括外科护理，带来了重大挑战。虽然许多研究都检查了大流行对不同患者结局的影响，但目前尚无研究检查大流行高峰对手术结局的影响。我们的目的是使用美国外科医师学会国家外科质量改进计划（ACS-NSQIP）数据库中的数据来评估 COVID-19 高峰对手术结局的影响。
对 2020 年 2 月至 2022 年 12 月期间接受手术的 7436 名患者进行了单中心回顾性分析。患者分为大流行高峰期间（n=1217）和该期间之外（n=6219）接受手术的患者。主要结局是 30 天死亡率和发病率。次要结局包括 30 天死亡率、手术时间、输血、再次手术和特定的术后并发症。我们的分析使用了多变量逻辑回归。所有分析均使用软件“R”版本 4.2.1 进行。统计显著性设置为α=0.05 水平。
在调整了混杂因素后，我们发现两组之间 30 天死亡率和发病率（OR：1.06，95%CI：0.89-1.226，=0.5173）或仅 30 天死亡率（OR：1.39，95%CI：0.788-2.14，=0.1364）无显著差异。次要结局无显著差异。敏感性分析得出的结果与多变量逻辑回归相似。
我们发现，与大流行高峰期间接受手术的患者相比，在大流行高峰期间接受手术的患者 30 天死亡率和发病率没有增加。我们的结果表明，尽管面临大流行高峰的挑战，但外科护理得以维持。
