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Risk Factors Associated With Postoperative Mortality Among COVID-19 Positive Patients: Results of 3027 Operations and
Sumeyye Yilmaz1, Ipek Sapci1, Xue Jia2
1Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Main Campus, Cleveland, OH.
Annals of Surgery
|September 20, 2022
Summary
Older age, smoking, comorbidities, and emergency surgeries increase postoperative mortality risk in patients with coronavirus disease 2019 (COVID-19). Careful pre-intervention evaluation is crucial for these high-risk patients.
Area of Science:
- Surgical Outcomes
- Infectious Diseases
- Critical Care Medicine
Background:
- Patients with coronavirus disease 2019 (COVID-19) experience increased postoperative complications.
- Limited research exists on risk factors for postoperative mortality in COVID-19 positive surgical patients.
Purpose of the Study:
- To identify predictors of 30-day postoperative mortality in patients who tested positive for COVID-19.
- To analyze secondary outcomes including length of stay, ICU admission, and readmission rates.
Main Methods:
- Retrospective analysis of 2543 COVID-19 positive patients undergoing 3027 surgeries/procedures at Cleveland Clinic (January 2020 - March 2021).
- Primary outcome: 30-day postoperative/procedural mortality.
- Multivariable analysis to identify significant risk factors.
Main Results:
- The postoperative mortality rate was 4.01%.
- Predictors of mortality included advanced age, current smoking, comorbidities, emergency/urgent surgery, emergency department admission, and inpatient status.
- Thoracic surgery cases showed the highest mortality association. Increased BMI predicted ICU admission.
Conclusions:
- COVID-19 positive patients face elevated post-intervention mortality risk.
- Thorough pre-procedural risk assessment is essential.
- Further research is needed on the pandemic's long-term surgical outcome impact.
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