Xiong Xiaojuan, Li Rui, Pei Haoyu, Mao Qingxiang
Department of Anesthesiology, Army Medical Center of PLA, Daping Hospital, Army Medical University, 10 ChangjiangZhilu, Yuzhong District, Chongqing 400042, China.
Int J Med Sci. 2024 Feb 17;21(4):742-754. doi: 10.7150/ijms.88727. eCollection 2024.
We aimed to investigate the impact of Omicron variant infection on the perioperative organ function in patients undergoing elective surgery. A total of 5029 patients who underwent elective surgery between October 2022 and January 2023 at our hospital were enrolled. Among them, the patients who underwent elective surgery between October 2022 and November 2022 composed Group 1 (not infected with the Omicron variant) the control group; those who underwent elective surgery between December 2022 and January 2023 composed Group 2 (one month after Omicron variant infection) the experimental group. We further divided the patients into two subgroups for analysis: the tumor subgroup and the nontumor subgroup. Data on organ system function indicators, including coagulation parameters, liver function, complete blood count (CBC), and kidney function, were collected before and after surgery. Differences between the two groups were subsequently analyzed via binary logistic regression analysis. Compared with those in the uninfected patient group, the following changes were observed in patients with Omicron variant infection who underwent elective surgery one month after infection: prothrombin activity (PTa), prothrombin time (PT), fibrinogen, albumin/globulin, alanine aminotransferase (ALT), mean corpuscular hemoglobin concentration (MCHC), platelet (PLT), and anemia were increased AST/ALT, indirect bilirubin (IBILI), eosinophils, and uric acid were decreased before surgery; and lung infection/pneumonia and fibrinogen were increased, while AST/ALT, globulin, total bilirubin (TBIL), white blood cell count (WBC), and uric acid were decreased after surgery. There was no significant difference in the mortality rate or length of hospital stay (LOS) between the two groups. Subgroup analysis revealed elevated monocyte, PLT, and fibrinogen classification, levels and decreased globulin, prealbumin (PBA), eosinophil, and uric acid levels in the tumor subgroup of patients who underwent elective surgery one month after Omicron infection compared with those in the uninfected patients. Compared with the nontumor subgroup, fibrinogen levels, lung infection/pneumonia, TBIL, and PLT count were increased in the uninfected patients, while the globulin and eosinophil levels were decreased. Compared with uninfected patients, patients who underwent elective surgery one month after Omicron variant infection exhibited minimal changes in perioperative coagulation parameters, liver function, CBC counts, and kidney function. Additionally, no significant differences in postoperative mortality or LOS were observed between the two groups.
我们旨在研究奥密克戎变异株感染对接受择期手术患者围手术期器官功能的影响。纳入了2022年10月至2023年1月在我院接受择期手术的5029例患者。其中，2022年10月至2022年11月接受择期手术的患者组成第1组（未感染奥密克戎变异株）即对照组；2022年12月至2023年1月接受择期手术的患者组成第2组（奥密克戎变异株感染后1个月）即试验组。我们进一步将患者分为两个亚组进行分析：肿瘤亚组和非肿瘤亚组。收集手术前后器官系统功能指标数据，包括凝血参数、肝功能、全血细胞计数（CBC）和肾功能。随后通过二元逻辑回归分析两组之间的差异。与未感染患者组相比，感染奥密克戎变异株后1个月接受择期手术的患者出现以下变化：术前凝血酶原活性（PTa）、凝血酶原时间（PT）、纤维蛋白原、白蛋白/球蛋白、丙氨酸氨基转移酶（ALT）、平均红细胞血红蛋白浓度（MCHC）、血小板（PLT）和贫血增加，谷草转氨酶/谷丙转氨酶（AST/ALT）、间接胆红素（IBILI）、嗜酸性粒细胞和尿酸降低；术后肺部感染/肺炎和纤维蛋白原增加，而AST/ALT、球蛋白、总胆红素（TBIL）、白细胞计数（WBC）和尿酸降低。两组之间的死亡率或住院时间（LOS）无显著差异。亚组分析显示，与未感染患者相比，奥密克戎感染后1个月接受择期手术的患者肿瘤亚组中单核细胞、PLT和纤维蛋白原分类水平升高，球蛋白、前白蛋白（PBA）、嗜酸性粒细胞和尿酸水平降低。与非肿瘤亚组相比，未感染患者的纤维蛋白原水平、肺部感染/肺炎、TBIL和PLT计数增加，而球蛋白和嗜酸性粒细胞水平降低。与未感染患者相比，感染奥密克戎变异株后1个月接受择期手术的患者围手术期凝血参数、肝功能、CBC计数和肾功能变化最小。此外，两组术后死亡率或LOS无显著差异。
