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Postoperative pneumonia after bariatric surgery during the COVID-19 pandemic: a National Surgical Quality Improvement
Rachel Grosser1, Gustavo Romero-Velez2, Xavier Pereira1
1Department of Surgery, Montefiore Medical Center, Bronx, New York.
Background:
During the COVID-19 pandemic, surgical centers had to weigh the benefits and risks of conducting bariatric surgery. Obesity increases the risk of developing severe COVID-19 infections, and therefore, bariatric surgery is beneficial. In contrast, surgical patients who test positive for COVID-19 have higher mortality rates.
Objective:
This study investigates the national prevalence of postoperative pneumonia during the COVID-19 pandemic in the bariatric surgery population.
Setting:
The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database.
Methods:
This is a cross-sectional study using the ACS-NSQIP database. The population of concern included patients who underwent sleeve gastrectomy and Roux-en-Y gastric bypass procedures. Information was extracted on rate of postoperative pneumonia and other 30-day complications between 2018 and 2020.
Results:
All baseline characteristics were similar among patients who underwent bariatric surgery between 2018 and 2020. However, there was a 156% increase in postoperative pneumonia in 2020 compared with the previous year. Furthermore, despite the similar postoperative complication rates across the years, there was a statistically significant increase in all-cause mortality in 2020. The multivariate analysis showed that having surgery in 2020 was a statistically significant risk factor for pneumonia development postoperatively.
Conclusions:
This study showed a statistically significant increase in the prevalence of postoperative pneumonia during the COVID-19 pandemic among bariatric surgery patients. Surgical centers must continuously evaluate the risks associated with healthcare-associated exposure to COVID-19 and weigh the benefits of bariatric surgery.
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