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

Year 2024, Volume: 4 Issue: 2, 48 - 55, 22.08.2024
https://doi.org/10.58961/hmj.1469347

Abstract

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.

References

  • Nepogodiev D, Bhangu A, Glasbey JC, Li E, Omar OM, Simoes JF, et al. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020 Jul 4;396(10243):27-38.
  • Rivett L, Sridhar S, Sparkes D, Routledge M, Jones NK Forrest S, et al. Screening of healthcare workers for SARSCoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission. Elife. 2020 May 11;9:e58728.
  • Machhi J, Herskovitz J, Senan AM, Dutta D, Nath B, Oleynikov MD, et al. The Natural History, Pathobiology, and Clinical Manifestations of SARS-CoV-2 Infections. J Neuroimmune Pharmacol. 2020 Sep;15(3):359-86.
  • Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 Apr 7;323(13):1239-42.
  • Nepogodiev D, Simoes JF, Li E, Picciochi M, Glasbey JC, Baiocchi G, et al. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia. 2021 Jun;76(6):748-58.
  • Amodeo G, Bugada D, Franchi S, Moschetti G, Grimaldi S, Panerai A, et al. Immune function after major surgical interventions: the effect of postoperative pain treatment. J Pain Res. 2018;11:1297-305.
  • Mathew G, Agha R, Albrecht J, Goel P, Mukherjee I, Pai P, et al. STROCSS 2021: Strengthening the reporting of cohort, cross-sectional and case-control studies in surgery. Int J Surg. 2021 Dec;96:106165. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 Feb 15;395(10223):507-13.
  • Baiocchi G, Aguiar S, Duprat JP, Coimbra FJF, Makdiss FB, Vartanian JG, et al. Early postoperative outcomes among patients with delayed surgeries after preoperative positive test for SARS-CoV-2: A case-control study from a single institution. J Surg Oncol. 2021 Mar;123(4):823-33.
  • Doglietto F, Vezzoli M, Gheza F, Lussardi GL, Domenicucci M, Vecchiarelli L, et al. Factors Associated With Surgical Mortality and Complications Among Patients With and Without Coronavirus Disease 2019 (COVID-19) in Italy. JAMA Surg. 2020 Aug 1;155(8):691-702.
  • Kumar P, Renuka MK, Kalaiselvan MS, Arunkumar AS. Outcome of Noncardiac Surgical Patients Admitted to a Multidisciplinary Intensive Care Unit. Indian J Crit Care Med. 2017 Jan;21(1):17-22.
  • Lei S, Jiang F, Su W, Chen C, Chen J, Mei W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine. 2020 Apr;21:100331.
  • Inzunza M, Romero C, Irarrázaval MJ, Ruiz-Esquide M, Achurra P, Quezada N, et al. Morbidity and Mortality in Patients with Perioperative COVID-19 Infection: Prospective Cohort in General, Gastroesophagic, Hepatobiliary, and Colorectal Surgery. World J Surg. 2021 Jun;45(6):1652-62.
  • Abate SM, Mantefardo B, Basu B. Postoperative mortality among surgical patients with COVID-19: a systematic review and meta-analysis. Patient Saf Surg. 2020;14:37.
  • Lal BK, Prasad NK, Englum BR, Turner DJ, Siddiqui T Carlin MM, et al. Periprocedural complications in patients with SARS-CoV-2 infection compared to those without infection: A nationwide propensity-matched analysis. Am J Surg. 2021 Aug;222(2):431-7.
  • Stawicki SP, Jeanmonod R, Miller AC, Paladino L, Gaieski DF, Yaffee AQ, et al. The 2019-2020 Novel Coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2) Pandemic: A Joint American College of Academic International Medicine-World Academic Council of Emergency Medicine Multidisciplinary COVID-19 Working Group Consensus Paper. J Glob Infect Dis. 2020;12(2):47-93.
  • Cai M, Wang G, Zhang L, Gao J, Xia Z, Zhang P, et al. Performing abdominal surgery during the COVID-19 epidemic in Wuhan, China: a single-centred, retrospective, observational study. Br J Surg. 2020 Jun;107(7):e183-e185.

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

Year 2024, Volume: 4 Issue: 2, 48 - 55, 22.08.2024
https://doi.org/10.58961/hmj.1469347

Abstract

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.

References

  • Nepogodiev D, Bhangu A, Glasbey JC, Li E, Omar OM, Simoes JF, et al. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020 Jul 4;396(10243):27-38.
  • Rivett L, Sridhar S, Sparkes D, Routledge M, Jones NK Forrest S, et al. Screening of healthcare workers for SARSCoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission. Elife. 2020 May 11;9:e58728.
  • Machhi J, Herskovitz J, Senan AM, Dutta D, Nath B, Oleynikov MD, et al. The Natural History, Pathobiology, and Clinical Manifestations of SARS-CoV-2 Infections. J Neuroimmune Pharmacol. 2020 Sep;15(3):359-86.
  • Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 Apr 7;323(13):1239-42.
  • Nepogodiev D, Simoes JF, Li E, Picciochi M, Glasbey JC, Baiocchi G, et al. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia. 2021 Jun;76(6):748-58.
  • Amodeo G, Bugada D, Franchi S, Moschetti G, Grimaldi S, Panerai A, et al. Immune function after major surgical interventions: the effect of postoperative pain treatment. J Pain Res. 2018;11:1297-305.
  • Mathew G, Agha R, Albrecht J, Goel P, Mukherjee I, Pai P, et al. STROCSS 2021: Strengthening the reporting of cohort, cross-sectional and case-control studies in surgery. Int J Surg. 2021 Dec;96:106165. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 Feb 15;395(10223):507-13.
  • Baiocchi G, Aguiar S, Duprat JP, Coimbra FJF, Makdiss FB, Vartanian JG, et al. Early postoperative outcomes among patients with delayed surgeries after preoperative positive test for SARS-CoV-2: A case-control study from a single institution. J Surg Oncol. 2021 Mar;123(4):823-33.
  • Doglietto F, Vezzoli M, Gheza F, Lussardi GL, Domenicucci M, Vecchiarelli L, et al. Factors Associated With Surgical Mortality and Complications Among Patients With and Without Coronavirus Disease 2019 (COVID-19) in Italy. JAMA Surg. 2020 Aug 1;155(8):691-702.
  • Kumar P, Renuka MK, Kalaiselvan MS, Arunkumar AS. Outcome of Noncardiac Surgical Patients Admitted to a Multidisciplinary Intensive Care Unit. Indian J Crit Care Med. 2017 Jan;21(1):17-22.
  • Lei S, Jiang F, Su W, Chen C, Chen J, Mei W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine. 2020 Apr;21:100331.
  • Inzunza M, Romero C, Irarrázaval MJ, Ruiz-Esquide M, Achurra P, Quezada N, et al. Morbidity and Mortality in Patients with Perioperative COVID-19 Infection: Prospective Cohort in General, Gastroesophagic, Hepatobiliary, and Colorectal Surgery. World J Surg. 2021 Jun;45(6):1652-62.
  • Abate SM, Mantefardo B, Basu B. Postoperative mortality among surgical patients with COVID-19: a systematic review and meta-analysis. Patient Saf Surg. 2020;14:37.
  • Lal BK, Prasad NK, Englum BR, Turner DJ, Siddiqui T Carlin MM, et al. Periprocedural complications in patients with SARS-CoV-2 infection compared to those without infection: A nationwide propensity-matched analysis. Am J Surg. 2021 Aug;222(2):431-7.
  • Stawicki SP, Jeanmonod R, Miller AC, Paladino L, Gaieski DF, Yaffee AQ, et al. The 2019-2020 Novel Coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2) Pandemic: A Joint American College of Academic International Medicine-World Academic Council of Emergency Medicine Multidisciplinary COVID-19 Working Group Consensus Paper. J Glob Infect Dis. 2020;12(2):47-93.
  • Cai M, Wang G, Zhang L, Gao J, Xia Z, Zhang P, et al. Performing abdominal surgery during the COVID-19 epidemic in Wuhan, China: a single-centred, retrospective, observational study. Br J Surg. 2020 Jun;107(7):e183-e185.
There are 16 citations in total.

Details

Primary Language English
Subjects Surgery (Other)
Journal Section Research Articles
Authors

Yunushan Furkan Aydoğdu 0000-0002-2418-2393

Mustafa Örmeci 0000-0001-5819-8484

Ali Haldun Özcan 0009-0004-6490-7880

Yeşim Akdeniz 0000-0001-7820-7448

Alpaslan Fedayi Çalta 0000-0001-8372-0991

Serhat Oğuz 0000-0003-0242-3472

Publication Date August 22, 2024
Submission Date April 16, 2024
Acceptance Date July 18, 2024
Published in Issue Year 2024 Volume: 4 Issue: 2

Cite

Vancouver Aydoğdu YF, Örmeci M, Özcan AH, Akdeniz Y, Çalta AF, Oğuz S. The effect of comorbid conditions on postoperative morbidity in COVID-19 test positive patients undergoing emergency surgery, a descriptive study. HMJ. 2024;4(2):48-55.

e-ISSN: 2791-9935