Hemrajani Manisha, Mongia Pooja, Gupta Pushplata, Joad Anjum K
Department of Anaesthesiology and Palliative Medicine, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India.
Department of Anaesthesiology and Palliative Medicine, Mahatama Gandhi Hospital and Research Centre, Jaipur, Rajasthan, India.
J Anaesthesiol Clin Pharmacol. 2024 Oct-Dec;40(4):645-652. doi: 10.4103/joacp.joacp_232_23. Epub 2024 Jun 27.
Post-Covid-19 cancer patients are likely to have poor postoperative outcomes following cancer surgeries. This is mainly because of the coexisting risk factors unique to cancer patients like immunosuppression, chemotherapy, and radiotherapy-induced risk of infection and malnutrition. The purpose of this study was to compare the postoperative morbidity in cancer patients with and without a history of Covid infection.
This was a prospective observational study. Subjects were divided into post-Covid 19 (PC) and non-Covid 19 (NC) groups based on the history of SARS CoV2. Preoperative data including details of past Covid infection, chemotherapy, radiotherapy, comorbidity index, Portsmouth-Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (P-POSSUM) score, and nutritional indices were recorded for patients undergoing elective cancer surgery. Thirty-day postoperative morbidity, mortality was recorded.
Of the total patients ( = 414), 109 had postoperative complications (26.33%), reported to be higher in the PC group (33.87%) than the NC (25%) ( value: 0.19). Pulmonary complications were commonest with higher incidence in PC (25.8%) group ( value: 0.001). It was 40% in 2-4 weeks after Covid 19 diagnosis reducing to 18% and 25% in 4-8 weeks and 8-12 weeks, respectively. The overall mortality rate was 0.72%. P-POSSUM morbidity score was similar between the two groups. (PC: 38.30 ± 19.4; Covid negative 37.8 ± 16.7 value 0.84). Old age, hypothyroidism, and low Prognostic nutritional index were associated with a higher incidence of complications.
Cancer patients with a history of Covid infection undergoing elective surgery are at a higher risk of postoperative pulmonary complications.
新冠病毒感染康复后的癌症患者在癌症手术后可能会有较差的术后结局。这主要是因为癌症患者存在一些特有的共存风险因素，如免疫抑制、化疗以及放疗导致的感染和营养不良风险。本研究的目的是比较有和没有新冠病毒感染史的癌症患者的术后发病率。
这是一项前瞻性观察研究。根据严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染史将受试者分为新冠病毒感染康复后（PC）组和未感染新冠病毒（NC）组。记录接受择期癌症手术患者的术前数据，包括既往新冠病毒感染细节、化疗、放疗、合并症指数、用于计算死亡率和发病率的朴茨茅斯生理和手术严重程度评分（P-POSSUM）以及营养指标。记录术后30天的发病率和死亡率。
在总共414例患者中，109例有术后并发症（26.33%），据报告PC组（33.87%）的并发症发生率高于NC组（25%）（P值：0.19）。肺部并发症最为常见，PC组（25.8%）的发生率更高（P值：0.0 01）。在新冠病毒感染诊断后2至4周时为40%，在4至8周和8至12周时分别降至18%和25%。总体死亡率为0.72%。两组之间的P-POSSUM发病率评分相似。（PC组：38.30±19.4；新冠病毒检测阴性组37.8±16.7，P值0.84）。老年、甲状腺功能减退和低预后营养指数与较高的并发症发生率相关。
有新冠病毒感染史的癌症患者接受择期手术时术后肺部并发症风险更高。
