Novel Use Of Age-Adjusted Charlson Comorbidity Index (ACCI) As A Risk Stratification Tool For Development Of...

Area of Science:

• Surgical Oncology
• Infectious Diseases
• Epidemiology

Background:

• The study investigates the Age-adjusted Charlson Comorbidity Index (ACCI) as a tool for stratifying surgical patients based on their risk of developing postoperative SARS-CoV-2 infection.
• Understanding these risks is crucial for implementing appropriate patient management strategies during the COVID-19 pandemic.

Purpose of the Study:

• To evaluate the effectiveness of the ACCI in predicting the likelihood of postoperative SARS-CoV-2 infection in surgical patients.
• To identify specific surgical procedures and patient factors associated with an increased risk of infection.

Main Methods:

• A prospective cohort study was conducted over 8 weeks, including consecutive patients undergoing surgery.
• Follow-up was maintained for 30 days to assess outcomes, including SARS-CoV-2 infection, morbidity, and mortality.
• Univariate and multivariate analyses were used to identify risk factors for infection.

Main Results:

• Postoperative SARS-CoV-2 infection occurred in 37 patients (22% of the cohort).
• Factors significantly increasing infection risk included higher ACCI scores (≥4), emergency surgery, trauma, orthopedic/vascular procedures, and spinal anesthesia.
• Patients with an ACCI of 0 had a 1.9% infection rate, while those with an ACCI of 4 or more had a 36.26% infection rate.

Conclusions:

• The ACCI is a valuable tool for stratifying surgical patients into low (ACCI=0), intermediate (ACCI=1-3), and high (ACCI≥4) risk groups for postoperative SARS-CoV-2 infection.
• Recommendations include universal precautions for low-risk, extra precautions for intermediate-risk, and considering surgery cancellation, delay, or enhanced isolation for high-risk patients.