Acil cerrahi girişim uygulanan COVID-19 testi pozitif hastalarda komorbid durumların postoperatif morbiditeye etkisi, Tanımlayıcı bir Çalışma

Yıl 2024, Cilt: 4 Sayı: 2, 48 - 55, 22.08.2024

Yunushan Furkan Aydoğdu , Mustafa Örmeci , Ali Haldun Özcan , Yeşim Akdeniz , Alpaslan Fedayi Çalta , Serhat Oğuz

https://doi.org/10.58961/hmj.1469347

Öz

Amaç: COVID-19-pozitif hastaların cerrahi prosedürlere tabi tutulması komplikasyon riskini artırabilir ve tedavi sürecini daha karmaşık hale getirebilir. Çalışmamızın amacı COVID-19-pozitif hastalara uygulanan acil cerrahi girişimler sonrası komplikasyonları araştırmak ve bu hastalarda komorbid durumların postoperatif morbidite üzerindeki etkisini incelemektir.
Gereç ve Yöntem: 1 Nisan 2020 ile 1 Aralık 2022 tarihleri arasında kliniğimizde gerçekleştirilen acil abdominal cerrahi girişimler değerlendirildi. Çalışmada, preoperatif dönemde COVID-19 testi pozitif çıkan hastalarda preoperatif komorbiditelerin postoperatif mortalite üzerindeki etkisi araştırıldı. Hastane kayıtları retrospektif kohort çalışması yöntemiyle taranarak bağımlı değişkenler (mortalite, morbidite (serebrovasküler hastalık, diabetes mellitus, hipertansiyon, kanser, sigara, kronik böbrek hastalığı ve kronik kalp hastalığı), hastanede kalış süresi) ve bağımsız değişkenler (cinsiyet, yaş, anestezi tipi, ASA değerlendirme sınıfı ve preoperatif laboratuvar parametreleri (hemoglobin, lökosit sayısı, d-dimer ve C reaktif protein)) arasındaki ilişki incelenecektir: Diabetes mellitus postoperatif morbidite ile anlamlı olarak ilişkiliydi (p=0.04). Ancak, diğer komorbid durumlar ile postoperatif morbidite arasında istatistiksel olarak anlamlı bir ilişki bulunmadı. Komorbid durumlar ile postoperatif mortalite arasında anlamlı bir fark bulunmamıştır. Regresyon analizi ayrıca diabetes mellitus ile postoperatif komplikasyonlar arasında istatistiksel olarak anlamlı bir ilişki olduğunu ortaya koydu (p=0.024).
Sonuç: Çalışmamızda, acil cerrahi uygulanan COVID-19 pozitif hastalarda komorbid diabetes mellitus durumunun postoperatif morbidite üzerinde etkili olduğu bulunmuştur. Bu hastaların ameliyat öncesi ayrıntılı değerlendirilmesi ameliyat sonrası morbiditeyi azaltacaktır.

Anahtar Kelimeler

COVID-19, Acil Cerrahi, Abdominal Cerrahi, Komorbidite, Postoperatif Morbidite.

The effect of comorbid conditions on postoperative morbidity in COVID-19 test positive patients undergoing emergency surgery, a descriptive study

Öz

Objective: Subjecting COVID-19-positive patients to surgical procedures might heighten the risk of complications and make the treatment process more complex. Our study aims to investigate the complications following emergency surgical interventions performed in COVID-19-positive patients and to examine the impact of comorbid conditions on postoperative morbidity in these patients on postoperative morbidity.
Material and Method: Between April 1, 2020, and December 1, 2022, emergency abdominal surgical interventions performed in our clinics were evaluated. The study examined the impact of preoperative comorbidities on postoperative mortality in patients who tested positive for COVID-19 positive in the preoperative period was investigated. Hospital records will be scanned using a retrospective cohort study method to examine the relationship between dependent variables (mortality, morbidity (cerebrovascular disease, diabetes mellitus, hypertension, cancer, smoking, chronic kidney disease, and chronic heart disease), length of hospital stay) and independent variables (gender, age, type of anesthesia, ASA assessment class, and preoperative laboratory parameters (hemoglobin, leukocyte count, d-dimer, and C reactive protein)).
Results: Diabetes mellitus was significantly associated with postoperative morbidity (p=0.04). However, no statistically significant relationship was found between other comorbid conditions and postoperative morbidity. There was no significant difference between comorbid conditions and postoperative mortality. Regression analysis also revealed a statistically significant association between diabetes mellitus and postoperative complications (p=0.024).
Conclusion: In our study found that comorbid diabetes mellitus status had an impact on postoperative morbidity in COVID-19 positive patients undergoing emergency surgery. Detailed preoperative evaluation of these patients before surgery will decrease postoperative morbidity.

Anahtar Kelimeler

COVID-19, Emergency Surgery, Abdominal Surgery, Comorbidity, Postoperative Morbidity.

Kaynakça

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