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Article: Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study
Title | Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study |
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Authors | |
Keywords | COVID-19 SARS-CoV-2 delay surgery timing |
Issue Date | 2021 |
Publisher | Wiley-Blackwell Publishing Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2044 |
Citation | Anaesthesia, 2021, v. 76 n. 6, p. 748-758 How to Cite? |
Abstract | Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0–2 weeks, 3–4 weeks and 5–6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3–4.8), 3.9 (2.6–5.1) and 3.6 (2.0–5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9–2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2–8.7) vs. 2.4% (95%CI 1.4–3.4) vs. 1.3% (95%CI 0.6–2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay. |
Description | Hybrid open access |
Persistent Identifier | http://hdl.handle.net/10722/302037 |
ISSN | 2023 Impact Factor: 7.5 2023 SCImago Journal Rankings: 2.400 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | COVIDSurg Collaborative | - |
dc.contributor.author | GlobalSurg Collaborative | - |
dc.contributor.author | Su, Yuxiong | - |
dc.contributor.author | Pu, Jingya | - |
dc.date.accessioned | 2021-08-21T03:30:39Z | - |
dc.date.available | 2021-08-21T03:30:39Z | - |
dc.date.issued | 2021 | - |
dc.identifier.citation | Anaesthesia, 2021, v. 76 n. 6, p. 748-758 | - |
dc.identifier.issn | 0003-2409 | - |
dc.identifier.uri | http://hdl.handle.net/10722/302037 | - |
dc.description | Hybrid open access | - |
dc.description.abstract | Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0–2 weeks, 3–4 weeks and 5–6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3–4.8), 3.9 (2.6–5.1) and 3.6 (2.0–5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9–2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2–8.7) vs. 2.4% (95%CI 1.4–3.4) vs. 1.3% (95%CI 0.6–2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay. | - |
dc.language | eng | - |
dc.publisher | Wiley-Blackwell Publishing Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2044 | - |
dc.relation.ispartof | Anaesthesia | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | COVID-19 | - |
dc.subject | SARS-CoV-2 | - |
dc.subject | delay | - |
dc.subject | surgery | - |
dc.subject | timing | - |
dc.title | Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study | - |
dc.type | Article | - |
dc.identifier.email | Su, Y: richsu@hku.hk | - |
dc.identifier.authority | Su, Y=rp01916 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1111/anae.15458 | - |
dc.identifier.pmid | 33690889 | - |
dc.identifier.pmcid | PMC8206995 | - |
dc.identifier.scopus | eid_2-s2.0-85102236123 | - |
dc.identifier.hkuros | 324272 | - |
dc.identifier.volume | 76 | - |
dc.identifier.issue | 6 | - |
dc.identifier.spage | 748 | - |
dc.identifier.epage | 758 | - |
dc.identifier.isi | WOS:000626707000001 | - |
dc.publisher.place | United Kingdom | - |