Evaluation of Perioperative Complications and Mortality in Covid-19 Patients Who Had Emergency Surgery

Year 2022, , 932 - 938, 30.12.2022

Hamide Ayben Korkmaz , İlkay Ceylan

https://doi.org/10.33808/clinexphealthsci.1007516

Abstract

Objective: The risk for adverse outcomes in COVID-19 patients necessitates further scrutiny in Covid 19 patients in providing appropriate surgical indications and perioperative surgical safety precautions. In this study, we aimed to contribute to elective surgery resumption about infection with early and late postoperative complications and mortality in patients with RT-PCR (+) and clinically suspicious COVID-19 who underwent emergency surgery in our hospital. Methods: A total of 86 patients who have been operated on in our institution for emergency surgery over the age of 18 who were diagnosed with SARS-CoV-2 infection seven days before or 30 days after surgery were enrolled in the study. In this retrospective study, the primary outcome has been established as mortality factors and survival within postoperative 30 days. Results: Regarding the primary outcome as 30-day survival, every 1-year increase in age increased the risk of death by two folds. Patients with one or more comorbidities have an increased risk of death 13 times and those with two or more have an increased risk of death 23 times. Patients in intensive care units increase the risk of death by 8.5 times compared to those who are not hospitalized. On the contrary, an increase in hemoglobin level was shown to reduce the risk of death by 0.8 times. Conclusion: The need for intensive care and mortality is high, especially after emergency surgery, in patients with COVID19 symptoms and more than one comorbidity. Surgical indications of such patients should be well investigated.

Keywords

COVID-19, PCR, emergency surgery, surgery complications, pandemic

Project Number

2011-KAEK-25 2021/04-02

References

• [1] Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382(13):1199-1207
• [2] Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020;180 (7):934-943.
• [3] Vardhana SA, Wolchok JD. The many faces of the anti-COVID immune response. J Exp Med. 2020;217(6).
• [4] Vogel L. What’s next now that the WHO has declared a COVID-19 pandemic? CMA. 2020;192(13): 349-350.
• [5] Wu J, Wu X, Zeng W, Guo D, Fang Z, Chen L. Chest CT findings in patients with coronavirus disease 2019 and its relationship with clinical features. Invest Radiol. 2020;55: 257–261.
• [6] Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus Disease 2019 (COVID-19): A systematic review of imaging findings in 919 patients. AJR Am J Roentgenol. 2020. 215 (1),87-93.
• [7] Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020; 8(5): 475-481.
• [8] LIANG T. Handbook of COVID-19 Prevention and Treatment. The First Affiliated Hospital, Zhejiang University School of Medicine. Available at: https://orhb.gov.et/images/covid/ Handbook.pdf Accessed Dec 11, 2020. 14-15.
• [9] Luo Y, Zhong M. Standardized diagnosis and treatment of colorectal cancer during the outbreak of novel coronavirus pneumonia in Renji Hospital. Zhonghua Wei Chang Wai Ke Za Zhi 2020;23: 003.
• [10] Steinberg E, Balakrishna A, Habboushe J, Shawl A, Lee J. Calculated decisions: COVID-19 calculators during extreme resource-limited situations, Emerg Med Pract. 2020;22(4 Suppl):CD1-CD5.
• [11] Moghadas SM, Shoukat A, Fitzpatrick MC, Wells CR, Sah P, Pandey A. Projecting hospital utilization during the COVID-19 outbreaks in the United States. Proc Natl Acad Sci U S A. 2020;117(16):9122-9126.
• [12] Minno AD, Ambrosino P, Calcaterra I, Minno MCD. COVID-19 and venous thromboembolism: A meta-analysis of literature studies. Semin Thromb Hemost. 2020;46(7):763-771.
• [13] COVID Surg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. COVID Surg Collaborative Multicenter Study Lancet. 2020;396(10243):27-38.
• [14] COVID Surg Collabortive. Elective surgery cancellations due to the COVID-19 pandemic: Global predictive modelling to inform surgical recovery plans. Br J Surg 2020;1440–1449.
• [15] Kirchmeier E, Eriksson LI, Lewald H, Fagerlund MJ, Hoeft A, Hollmann M. Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study. Lancet Respir Med 2019; 7: 129–140.
• [16] Biccard BM, Madiba TE, Kluyts HL, Munlemvo DM, Madzimbamuto FD, Basenero A. Perioperative patient outcomes in the African Surgical Outcomes Study: A 7-day prospective observational cohort study. Lancet 2018; 391: 1589–1598.
• [17] Nahshon C, Bitterman A, Haddad R, Hazzan D, Lavie O. Hazardous postoperative outcomes of unexpected COVID-19 infected patients: A call for global consideration of sampling all asymptomatic patients before surgical treatment. World J Surg. 2020; 2:1–5.
• [18] Lei S, Jiang F, Su W, Chen C, Chen J, Mei W. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. Clinical Medicine 2020;21: 100331
• [19] Luca MD, Sartori A, Vitiello A, Piatto G, Noaro G, Olmi S. Complications and mortality in a cohort of patients undergoing emergency and elective surgery with perioperative SARS-CoV-2 infection: an Italian multicenter study. Teachings of Phase 1 to be brought in Phase 2 pandemic, Updates Surg. 2021;73(2):745-752.