Kannan Vaishnavi, Sharma J V Pranav
General Surgery, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND.
General Surgery, Adesh Medical College and Hospital, Shahbad, IND.
Cureus. 2024 Sep 8;16(9):e68965. doi: 10.7759/cureus.68965. eCollection 2024 Sep.
The delivery of surgical services was profoundly affected by the COVID-19 pandemic, resulting in the postponement of elective surgeries and a shift in focus to essential emergency procedures. Our study aimed to assess the impact of concurrent COVID-19 infection on complications, hospital stay, and recovery following emergency surgery. A retrospective matched cohort study was conducted between July 2020 and February 2022 at a tertiary care hospital in India. Data from 48 patients with COVID-19 infection in the immediate preoperative period was compared with 48 matched controls not infected with the virus. The data collected included patient demographics, surgical procedures, duration of hospital stay, and postoperative complications. Patients with concurrent COVID-19 infection had notably longer mean hospital stays (13.44 days) than the controls (6.63 days) (P = 0.002). An elevated proportion of COVID-19-positive patients experienced discharge delays (36 out of 48, 75%), compared to just six of the 48 non-COVID-19 patients (12.5%) (P ≤ 0.001). Postoperative findings in the COVID-positive cohort revealed elevated rates of pulmonary complications (5/48, 10.4%), higher rates of postoperative ICU admissions (8/48, 16.7%), and persistently elevated D-dimer levels extending beyond postoperative day seven (18/48, 37.5%). This suggests that emergency surgery in patients with COVID-19 is linked to significantly lengthier hospital stays, increased discharge delays, and a greater prevalence of adverse events in the postoperative period when compared to controls. These findings underscore the need for enhanced perioperative strategies and preparedness for potential future pandemics.
外科服务的提供受到新冠疫情的深远影响,导致择期手术推迟,重点转向基本的急诊手术。我们的研究旨在评估新冠病毒同时感染对急诊手术后并发症、住院时间和恢复情况的影响。2020年7月至2022年2月期间,在印度一家三级护理医院进行了一项回顾性匹配队列研究。将48例术前即刻感染新冠病毒的患者数据与48例未感染该病毒的匹配对照进行比较。收集的数据包括患者人口统计学信息、手术程序、住院时间和术后并发症。新冠病毒同时感染的患者平均住院时间(13.44天)明显长于对照组(6.63天)(P = 0.002)。与48例非新冠患者中的6例(12.5%)相比,新冠病毒阳性患者出院延迟的比例更高(48例中有36例,75%)(P≤0.001)。新冠病毒阳性队列的术后结果显示,肺部并发症发生率升高(5/48,10.4%),术后入住重症监护病房的比例更高(8/48,16.7%),术后第7天之后D-二聚体水平持续升高(18/48,37.5%)。这表明,与对照组相比,新冠病毒感染患者进行急诊手术与更长的住院时间、更多的出院延迟以及术后更高的不良事件发生率相关。这些发现强调了加强围手术期策略以及为未来可能发生的大流行做好准备的必要性。