2019年冠状病毒病手术患者的术后结局：一项回顾性队列研究

Postoperative Outcomes in Surgical Coronavirus Disease 2019 Patients: A Retrospective Cohort Study.

作者信息

Hegde Harihar V, Chackochan Aswathy, Al Bahri Raiya S, Abdullah Ramlaa Malallah, Paul Manisha, Kandachar Suman Subbaraya, Nair Sanjeev Gopalakrishnan, Weerasinghe Anjalika S, Kulikadavunkal Jayamohan, Mohnani Umesh Chandra

机构信息

Department of Anaesthesia and Intensive Care, Royal Hospital, Muscat, Sultanate of Oman.

出版信息

J Perianesth Nurs. 2025 Apr;40(2):277-280. doi: 10.1016/j.jopan.2024.04.004. Epub 2024 Aug 1.

DOI:10.1016/j.jopan.2024.04.004

PMID:39093233

Abstract

PURPOSE

Patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) who require surgical procedures are likely to experience higher postoperative mortality and morbidity. Our objective was to evaluate the perioperative course of patients infected with SARS-COV-2 undergoing surgical procedures. The purpose of this study was to describe the characteristics, outcomes, and the effect of the presence of symptoms.

DESIGN

Retrospective cohort.

METHODS

We analyzed the records of patients with SARS-CoV-2 infection who underwent surgical procedures from March 2020 to March 2021. Patients with ongoing infection at the time of surgery and those who had recently recovered were included. The primary outcome measure was 30-day in-hospital mortality after surgery. Secondary outcomes were intensive care unit (ICU) admission, length of stay in ICU, postoperative length of stay, and complications.

FINDINGS

Data from 102 patients were analyzed. Twenty-four patients (23.5%) died postoperatively in the hospital within 30 days. Forty-four patients required ICU admission (average stay 13 days). The median postoperative length of stay was 8 days (interquartile range, 3.75 to 19.25 days). Pulmonary, thromboembolic, and surgical complications were noted in 29 (28.4%), 14 (13.7%), and 18 (17.6%), respectively. Patients aged 41 to 60 years experienced higher rates of pulmonary and thromboembolic complications. Comparison of asymptomatic versus symptomatic patients revealed significantly higher 30-day in-hospital mortality (9 [15%] vs 15 [35.7%], P = .019), ICU admission (17 [28.3%] vs 27 [64.3%], P < .001), length of stay in ICU (3 [2 to 11.5] vs 18 [7 to 27], P = .001), postoperative length of stay (6 [3 to 10.75] vs 12 [5 to 25.25], P = .016) and pulmonary complication rates (11 [18.3%] vs 18 [42.9%], P = .008) in the symptomatic patients.

CONCLUSIONS

Symptomatic SARS-COV-2 patients undergoing surgical procedures experience significantly higher 30-day in-hospital mortality, ICU admission, longer ICU and hospital stay, and pulmonary complications.

摘要

目的

感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）且需要进行外科手术的患者术后死亡率和发病率可能更高。我们的目标是评估感染SARS-CoV-2的患者在接受外科手术时的围手术期过程。本研究的目的是描述其特征、结局以及症状存在的影响。

设计

回顾性队列研究。

方法

我们分析了2020年3月至2021年3月期间接受外科手术的SARS-CoV-2感染患者的记录。纳入手术时正在感染以及最近康复的患者。主要结局指标是术后30天内的住院死亡率。次要结局包括重症监护病房（ICU）入住情况、在ICU的住院时间、术后住院时间以及并发症。

结果

分析了102例患者的数据。24例患者（23.5%）在术后30天内死于医院。44例患者需要入住ICU（平均住院13天）。术后住院时间中位数为8天（四分位间距为3.75至19.25天）。分别有29例（28.4%）、14例（13.7%）和18例（17.6%）出现肺部、血栓栓塞和手术并发症。41至60岁的患者肺部和血栓栓塞并发症发生率更高。无症状患者与有症状患者的比较显示，有症状患者的30天内住院死亡率（9例[15%]对15例[35.7%]，P = 0.019）、ICU入住率（17例[28.3%]对27例[64.3%]，P < 0.001）、在ICU的住院时间（3天[2至11.5天]对18天[7至27天]，P = 0.001）、术后住院时间（6天[3至10.75天]对12天[5至25.25天]，P = 0.016）以及肺部并发症发生率（11例[18.3%]对18例[42.9%]，P = 0.008）均显著更高。