Vuu Steven K M, Liu Huazhi, Ang Darwin N
University of Central Florida College of Medicine, United States.
Ocala Regional Medical Center, Ocala, FL, United States.
Surg Pract Sci. 2023 Sep 16;15:100219. doi: 10.1016/j.sipas.2023.100219. eCollection 2023 Dec.
We hypothesized that COVID-19 positive patients requiring laparoscopic cholecystectomy (lap chole) or appendectomy (lap appy) would have increased inpatient mortality rates compared to all COVID-19 patients.
Retrospective cohort analysis including COVID-19 patients from 1/1/20 to 9/30/20. 82,574 cases identified. Patients excluded if <18 years old or underwent surgery other than lap chole or lap appy. Control groups were patients without surgery ( = 82,145). Exposure groups underwent lap chole ( = 323) or lap appy ( = 106). Primary outcome was inpatient mortality. Secondary outcomes included hospital length of stay (LOS) and complications such as bacterial pneumonia, deep venous thrombosis (DVT), pulmonary embolism (PE), urinary tract infection (UTI), acute myocardial infarction (MI), acute respiratory distress syndrome (ARDS), and respiratory failure (RF).
Overall inpatient mortality rate was 32.8% in COVID-19 patients undergoing lap chole (p-value <0.0001), 2.8 % lap appy (p-value 0.93), and 1.2 % in control group. ARDS complication rate was 11.2 % in lap chole (p-value <0.0001), 1.9 % lap appy (p-value 0.71), and 0.2 % in control.
COVID-19 patients during the initial wave of the pandemic who underwent lap chole during hospital admission had significantly higher risk of mortality and ARDS while lap appy did not.
我们假设，与所有新冠病毒病（COVID-19）患者相比，需要进行腹腔镜胆囊切除术（lap chole）或阑尾切除术（lap appy）的COVID-19阳性患者住院死亡率会升高。
进行回顾性队列分析，纳入2020年1月1日至9月30日的COVID-19患者。共识别出82,574例病例。年龄<18岁或接受除lap chole或lap appy以外手术的患者被排除。对照组为未接受手术的患者（n = 82,145）。暴露组接受lap chole（n = 323）或lap appy（n = 106）。主要结局为住院死亡率。次要结局包括住院时间（LOS）以及细菌肺炎、深静脉血栓形成（DVT）、肺栓塞（PE）、尿路感染（UTI）、急性心肌梗死（MI）、急性呼吸窘迫综合征（ARDS）和呼吸衰竭（RF）等并发症。
接受lap chole的COVID-19患者总体住院死亡率为32.8%（p值<0.0001），lap appy患者为2.8%（p值0.93），对照组为1.2%。ARDS并发症发生率在lap chole患者中为11.2%（p值<0.0001），lap appy患者中为1.9%（p值0.71），对照组为0.2%。
在疫情第一波期间住院接受lap chole的COVID-19患者死亡和发生ARDS的风险显著更高，而接受lap appy的患者则不然。
