围手术期严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染与术后并发症：中国一项单中心回顾性队列研究

Perioperative SARS-CoV-2 infection and postoperative complications: a single-centre retrospective cohort study in China.

作者信息

Zhan Jia, Zhong Fei, Dai LingYan, Ma Jue, Chai YunFei, Zhao XiRui, Chang Lu, Zhang YiDan, Wang JunJiang, Tang Yong, Zhong Wen-Zhao, Zhang Guangyan, Li Le, Zhu Qiang, Chen ZhiHao, Xia Xin, Peng LiShan, Wu Jing, Li RuiYun, Li DanYang, Zhu Yan, Zhou Xin, Wu YiChun, Chen RuiRong, Li Jie, Li Yong, Shu HaiHua

机构信息

Department of Anesthesiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

Global Health Research Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

出版信息

BMJ Open. 2025 May 19;15(5):e093044. doi: 10.1136/bmjopen-2024-093044.

DOI:10.1136/bmjopen-2024-093044

PMID:40389317

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12090866/

Abstract

OBJECTIVE

To explore the association between perioperative SARS-CoV-2 infection and the postoperative complications during the breakout of the Omicron epidemic wave.

DESIGN

Observational retrospective cohort study. Multivariable logistic regression was performed to explore the association between the duration from surgery to COVID-19 diagnosis and the likelihood of postoperative complications.

SETTING

A general hospital in China.

PARTICIPANTS

7927 patients aged 18 years and older who underwent surgical treatment between 1 December 2022 and 28 February 2023.

PRIMARY OUTCOME MEASURES

The outcome was a composite of postoperative adverse events that occurred within the initial 30 postoperative days.

RESULTS

Of all patients, 420 (11.76%) experienced postoperative complications. Compared with No COVID-19, preoperative COVID-19 within 1 week (pre-1w) exhibited a high risk of postoperative complications (adjusted OR (aOR), 2.67; 95% CI 1.50 to 4.78), followed by patients with pre-2w (aOR, 2.14; 95% CI 1.20 to 3.80). For patients with postoperative COVID-19 within 1 week (post-1w), the aOR was 2.48 (95% CI 1.48 to 4.13), followed by patients with post-2w (aOR 1.95; 95% CI 1.10 to 3.45), and those with post-3w (aOR 2.25; 95% CI 1.27 to 3.98). The risks of postoperative complications decreased roughly with the increase of the time interval between the surgery date and SARS-CoV-2 infection. Stratification analyses suggested that perioperative COVID-19 increased the risk of postoperative complications in older patients, smokers, those with comorbidities or experiencing moderate or severe COVID-19 symptoms.

CONCLUSIONS

Our findings reveal a significant time-dependent relationship between perioperative COVID-19 and postoperative complications, highlighting the importance of tailored preoperative risk evaluations, enhanced postoperative surveillance, and the implementation of effective postoperative COVID-19 prevention measures.

TRIAL REGISTRATION NUMBER

ChiCTR2300072473.

摘要

目的

探讨奥密克戎疫情暴发期间围手术期严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染与术后并发症之间的关联。

设计

观察性回顾性队列研究。采用多变量逻辑回归分析，以探究手术至新冠病毒病（COVID-19）诊断的时间与术后并发症发生可能性之间的关联。

地点

中国的一家综合医院。

研究对象

2022年12月1日至2023年2月28日期间接受手术治疗的7927例18岁及以上患者。

主要观察指标

观察指标为术后最初30天内发生的术后不良事件综合情况。

结果

在所有患者中，420例（5.30%）发生了术后并发症。与未感染COVID-19的患者相比，术前1周内感染COVID-19（术前1周内）的患者术后并发症风险较高（校正比值比（aOR）为2.67；95%置信区间为1.50至4.78），其次是术前2周内感染的患者（aOR为2.14；95%置信区间为1.20至3.80）。对于术后1周内感染COVID-19（术后1周内）的患者，aOR为2.48（95%置信区间为1.48至4.13），其次是术后2周内感染的患者（aOR为1.95；95%置信区间为1.10至3.45），以及术后3周内感染的患者（aOR为2.25；95%置信区间为1.27至3.98）。术后并发症风险大致随手术日期与SARS-CoV-2感染之间时间间隔的增加而降低。分层分析表明，围手术期感染COVID-19会增加老年患者、吸烟者、合并症患者或出现中度或重度COVID-19症状患者的术后并发症风险。