학술논문
Is Perioperative COVID-19 Really Associated with Worse Surgical Outcomes? A Nationwide COVIDSurg Propensity-Matched Analysis
Document Type
Academic Journal
Author
Argandykov, Dias; Dorken-Gallastegi, Ander; El Moheb, Mohamad; Gebran, Anthony; Proaño-Zamudio, Jefferson A.; Bokenkamp, Mary; Renne, Angela M.; Nepogodiev, Dmitri; Bhangu, Aneel; Kaafarani, Haytham M.A.; Siaw-Acheampong, Kwabena; Argus, Leah; Chaudhry, Daoud; Dawson, Brett E; Glasbey, James C.; Gujjuri, Rohan R; Jones, Conor S; Kamarajah, Sivesh K; Khatri, Chetan; Keatley, James M; Lawday, Samuel; Li, Elizabeth; Mann, Harvinder; Marson, Ella J.; Mclean, Kenneth A; Picciochi, Maria; Taylor, Elliott H; Tiwari, Abhinav; Simoes, Joana FF; Trout, Isobel M; Venn, Mary L; Wilkin, Richard JW; Bhangu, Aneel; Nepogodiev, Dmitri; Dajti, Irida; Gjata, Arben; Boccalatte, Luis; Modolo, Maria Marta; Cox, Daniel; Pockney, Peter; Townend, Philip; Aigner, Felix; Kronberger, Irmgard; Hossain, Kamral; VanRamshorst, Gabrielle; Lawani, Ismail; Ataide, Gustavo; Baiocchi, Glauco; Buarque, Igor; Gohar, Muhammad; Slavchev, Mihail; Agarwal, Arnav; Brar, Amanpreet; Martin, Janet; Modolo, Maria Marta; Olivos, Maricarmen; Calvache, Jose; Rivera, Carlos Jose Perez; Hadzibegovic, Ana Danic; Kopjar, Tomislav; Mihanovic, Jakov; Klat, Jaroslav; Novysedlak, René; Christensen, Peter; El-Hussuna, Alaa; Batista, Sylvia; Lincango, Eddy; Emile, Sameh H; Mengesha, Mengistu Gebreyohanes; Hailu, Samuel; Tamiru, Hailu; Kauppila, Joonas; Laukkarinen, Johanna; Arnaud, Alexis; Albertsmeiers, Markus; Lederhuber, Hans; Loffler, Markus; Tabiri, Stephen; Metallidis, Symeon; Tsoulfas, Georgios; Lorena, Maria Aguilera; Grecinos, Gustavo; Mersich, Tamas; Wettstein, Daniel; Ghosh, Dhruv; Kembuan, Gabriele; Brouk, Peiman; Khosravi, Mohammad; Mozafari, Masoud; Adil, Ahmed; Mohan, Helen M; Zmora, Oded; Fiore, Marco; Gallo, Gaetano; Pata, Francesco; Pellino, Gianluca; Satoi, Sohei; Ayasra, Faris; Chaar, Mohammad; Fakhradiyev, Ildar R; Jamal, Mohammad; Elhadi, Muhammed; Gulla, Aiste; Roslani, April; Martinez, Laura; De La Medina, Antonio Ramos; Outani, Oumaima; Jonker, Pascal; Kruijff, Schelto; Noltes, Milou; Steinkamp, Pieter; van der Plas, Willemijn; Ademuyiwa, Adesoji; Osinaike, Babatunde; Seyi-olajide, Justina; Williams, Emmanuel; Pejkova, Sofija; Augestad, Knut Magne; Al Balushi, Zainab; Qureshi, Ahmad; Sayyed, Raza; Daraghmeh, Mustafa Abu Mohsen; Abukhalaf, Sadi; Cukier, Moises; Gomez, Hugo; Shu, Sebastian; Vasquez, Ximena; Parreno-Sacdalan, Marie Dione; Major, Piotr; Azevedo, José; Cunha, Miguel; Santos, Irene; Zarour, Ahmad; Bonci, Eduard-Alexandru; Negoi, Ionut; Efetov, Sergey; Litvin, Andrey; Ntirenganya, Faustin; AlAmeer, Ehab; Radenkovic, Dejan; Xiang, Frederick Koh Hong; Hoe, Chew Min; Yong, James Ngu Chi; Moore, Rachel; Nhlabathi, Ncamsile; Colino, Ruth Blanco; Bravo, Ana Minaya; Minaya-Bravo, Ana; Jayarajah, Umesh; Wickramasinghe, Dakshitha; Elmujtaba, Mohammed; Jebril, William; Rutegård, Martin; Sund, Malin; Isik, Arda; Leventoğlu, Sezai; Abbott, Tom EF; Benson, Ruth; Caruna, Ed; Chakrabortee, Sohini; Demetriades, Andreas; Desai, Anant; Drake, Thomas D; Edwards, John G; Evans, Jonathan P; Ford, Samuel; Fotopoulou, Christina; Griffiths, Ewen; Hutchinson, Peter; Jenkinson, Michael D; Khan, Tabassum; Knight, Stephen; Kolias, Angelos; Leung, Elaine; McKay, Siobhan; Norman, Lisa; Ots, Riinu; Raghavan, Vidya; Roberts, Keith; Schache, Andrew; Shaw, Richard; Shaw, Katie; Smart, Neil; Stewart, Grant; Sundar, Sudha; Vimalchandran, Dale; Wright, Naomi; Alshryda, Sattar; Alser, Osaid; Breen, Kerry; Ganly, Ian; Kaafarani, Haytham; Kendall, Brittany; Mashbari, Hassan; Al Naggar, Hamza; Mazingi, Dennis; Simoes, Joana FF; Wong, JJ; Napolitano, L; Hemmila, M; Amin, D; Abramowicz, S; Roser, SM; Olson, KA; Riley, C; Heron, C; Cardenas, T; Leede, E; Thornhill, M; Haynes, AB; McElhinney, K; Roward, S; Trust, MD; Hill, CE; Teixeira, PG; Etchill, E; Stevens, K; Ladd, MR; Long, C; Rose, J; Kent, A; Yesantharao, P; Vervoort, D; Jenny, H; Gabre-Kidan, A; Margalit, A; Tsai, L; Malapati, H; Yesantharao, L; Abdou, H; Diaz, J; Richmond, M; Clark, J; OʼMeara, L; Hanna, N; Ying, Y; Fleming, J; Ovaitt, A; Gigliotti, J; Fuson, A; Cooper, Z; Salim, A; Hirji, SA; Brown, A; Chung, C; Hansen, L; Okafor, BU; Roxo, V; Raut, CP; Jolissaint, JS; Mahvi, DA; Kaafarani, H; Breen, K; Bankhead-Kendall, B; Alser, O; Mashbari, H; Velmahos, G; Maurer, LR; El Moheb, M; Gaitanidis, A; Naar, L; Christensen, MA; Kapoen, C; Langeveld, K; El Hechi, M; Mokhtari, A; Haqqani, MH; Drake, FT; Goldenberg-Sandau, A; Galbreath, B; Reinke, C; Ross, S; Thompson, K; Manning, D; Perkins, R; Eriksson, E; Evans, H; Masrur, M; Giulianotti, P; Benedetti, E; Chang, G; Ourieff, J; Dehart, D; Dorafshar, A; Price, T; Bhama, AR; Torquati, A; Cherullo, E; Kennedy, R; Myers, J; Rubin, K; Ban, VS; Aoun, SG; Batjer, HH; Caruso, J; Carmichael, H; Velopulos, CG; Wright, FL; Urban, S; McIntyre, RC, Jr; Schroeppel, TJ; Hennessy, EA; Dunn, J; Zier, L; Burlew, C; Coleman, J; Colling, KP; Hall, B; Rice, HE; Hwang, ES; Olson, SA; Moris, D; Verma, R; Hassan, R; Volpe, A; Merola, S; Flushing; OʼBanion, LA; Lilienstein, J; Dirks, R; Marwan, H; Almasri, M; Kulkarni, G; Mehdi, M; Abouassi, A; Abdallah, M; San Andrés, M; Eid, J; Aigbivbalu, E; Sundaresan, J; George, B; Ssentongo, A; Ssentongo, P; Oh, JS; Hazelton, J; Maines, J; Gusani, N; Garner, M; Horvath, S; Zheng, F; Ujiki, M; Kinnaman, G; Meagher, A; Sharma, I; Holler, E; McKenzie, K; Chan, J; Fretwell, K; Nugent, W, III; Khalil, A; Chen, D; Post, N; Rostkowski, T; Brahmbhatt, D; Huynh, K; Hibbard, ML; Schellenberg, M; Martin, RCG; Bhutiani, N; Giorgakis, E; Laryea, J; Bhavaraju, A; Sexton, K; Roberts, M; Kost, M; Kimbrough, M; Burdine, L; Kalkwarf, K; Gosain, A; Camp, L; Lewit, R; Kronenfeld, JP; Urrechaga, E; Goel, N; Rattan, R; Hart, V; Allen, M; Gilna, G; Cioci, A; Ruiz, G; Allen, M; Rakoczy, K; Pavlis, W; Saberi, R; Morris, R; Karam, BS; Brathwaite, CEM; Liu, H; Petrone, P; Hakmi, H; Sohail, AH; Baltazar, G; Heckburn, R; Nygaard, RM; Colonna, ET; Endorf, FW; Hill, MJ; Maiga, A; Dennis, B; Levin, JH; Lallemand, M; Choron, R; Peck, G; Soliman, F; Rehman, S; Glass, N; Juthani, B; Deisher, D; Ruzgar, NM; Ullrich, SJ; Sion, M; Paranjape, C; El Moheb, M; Kar, AR; Gillezeau, C; Rapp, J; Taioli, E; Miles, BA; Alpert, N; Podolsky, D; Coleman, NL; Callahan, MP; Ganly, I; Brown, L; Monson, JRT; Dehal, A; Abbas, A; Soliman, A; Kim, B; Jones, C; Dauer, MD E; Renza-Stingone, E; Hernandez, E; Gokcen, E; Kropf, E; Sufrin, H; Hirsch, H; Ross, H; Engel, J; Sewards, J; Diaz, J; Poggio, J; Sanserino, K; Rae, L; Philp, M; Metro, M; McNelis, P; Petrov, R; Rehman, S; Pazionis, T; Till, B; Lamm, R; Rios-Diaz, AJ; Palazzo, F; Rosengart, M; Nicholson, K; Carrick, MM; Rodkey, K; Suri, A; Callcut, R; Nicholson, S; Talathoti, N; Klaristenfeld, D; Biffl, W; Marsh, C; Schaffer, K; Berndtson, AE; Averbach, S; Curry, T; Kwan-Feinberg, R; Consorti, E; Gonzalez, R; Grolman, R; Liu, T; Merzlikin, O; Abel, MK; Ozgediz, D; Boeck, M; Kornblith, LZ; Nunez-Garcia, B; Robinson, B; Utria, AF; Rice-Townsend, SE; Javid, P; Hauptman, J; Kieran, K; Nehra, D; Walters, A; Cuschieri, J; Davidson, GH; Nunez, J; Cosker, R; Eckhouse, S; Choudhry, A; Marx, W; Jamil, T; Seegert, S; Al-Embideen, S; Quintana, M; Jackson, H; Wexner, SD; Kent, I; Martins, PN
Source
Journal of Trauma and Acute Care Surgery. Jan 19, 2023
Subject
Language
English
ISSN
2163-0755
Abstract
BACKGROUND: Patients undergoing surgery with perioperative COVID-19 are suggested to have worse outcomes, but whether this is COVID-related or due to selection bias remains unclear. We aimed to compare the postoperative outcomes of patients with and without perioperative COVID-19. METHODS: Patients with perioperative COVID-19 diagnosed within 7 days before or 30 days after surgery between February and July 2020 from 68 US hospitals in COVIDSurg, an international multicenter database, were 1:1 propensity score-matched to patients without COVID-19 undergoing similar procedures in the 2012 ACS-NSQIP database. The matching criteria included demographics (e.g., age, gender), comorbidities (e.g., diabetes, chronic obstructive pulmonary disease, chronic kidney disease), and operation characteristics (e.g., type, urgency, complexity). The primary outcome was 30-day hospital mortality. Secondary outcomes included hospital length of stay (LOS) and 13 postoperative complications (e.g., pneumonia, renal failure, surgical site infection). RESULTS: A total of 97,936 patients were included, 1,054 with and 96,882 without COVID-19. Pre-matching, COVID-19 patients more often underwent emergency surgery (76.1% vs. 10.3%, p < 0.001). A total of 843 COVID-19 and 843 non-COVID-19 patients were successfully matched based on demographics, comorbidities, and operative characteristics. Post-matching, COVID-19 patients had a higher mortality (12.0% vs. 8.1%, p = 0.007), longer LOS (6 [2-15] vs. 5 [1-12]) days, and higher rates of acute renal failure (19.3% vs. 3.0%, p < 0.001), sepsis (13.5% vs. 9.0%, p = 0.003), and septic shock (11.8% vs. 6.0%, p < 0.001). They also had higher rates of thromboembolic complications such as deep vein thrombosis (4.4% vs. 1.5%, p < 0.001), pulmonary embolism (2.5% vs. 0.4%, p < 0.001), but lower rates of bleeding (11.6% vs. 26.1%, p < 0.001). CONCLUSION: Patients undergoing surgery with perioperative COVID-19 have higher rates of 30-day mortality and postoperative complications, especially thromboembolic, compared to similar patients without COVID-19 undergoing similar surgeries. Such information is crucial for the complex surgical decision-making and counseling of these patients. LEVEL OF EVIDENCE: Prognostic and Epidemiologic; Level III.