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The Outcomes of Patients with Omicron Variant Infection who Undergo Elective Surgery: A Propensity-score-matched
Xiaojuan Xiong1, Rui Li1, Hong Yan1
1Department of Anesthesiology, Army Medical Center of PLA, Daping Hospital, Army Medical University, 10 ChangjiangZhilu, Yuzhong District, Chongqing 400042, China.
Abstract:
Aim: To investigate whether it is safe for patients with Omicron variant infection to undergo surgery during perioperative period. Methods: A total of 3,661 surgical patients were enrolled: 3,081 who were not infected with the Omicron variant and 580 who were infected with the Omicron variant. We conducted propensity score matching (PSM) with a ratio of 1:4 and a caliper value of 0.1 to match the infected and uninfected groups based on 13 variables. After PSM, we further divided the Infected group (560 cases) by the number of days between the preoperative Omicron variant infection and surgery: 0-7, 8-14, 15-30, and >30 days. Multivariate logistic regression analysis was subsequently conducted on the categorical variables and continuous variables with a P value below 0.05, thereby comparing the infected group (0-7, 8-14, 15-30, >30 days) and the uninfected group for perioperative complications. Results: Multivariate logistic regression analysis revealed that, compared to the uninfected group, among the four subgroups of the infected patients (0-7, 8-14, 15-30, >30 days), only renal insufficiency in the 8-14 days subgroup (OR: 0.09, 95%CI 0.01-0.74, P = 0.025) and anemia in the > 30 days subgroup (OR 0.6, 95%CI 0.4-0.9, P < 0.017) showed significant difference. However, there was no statistically significant difference in the incidence rate of blood transfusion, postoperative intensive care unit transfer, lung infection/pneumonia, pleural effusion, atelectasis, respiratory failure, sepsis, postoperative deep vein thrombosis, hypoalbuminemia, urinary tract infections, and medical expenses. Conclusion: Omicron infection does not significantly increase the risk of perioperative major complications. The Omicron infection may not be a sufficient risk factor to postpone elective surgery.
Insights
Omicron variant infection in surgical patients did not significantly increase major perioperative complications. Postponing elective surgery due to Omicron infection is likely unnecessary.
Area of Science:
- Infectious Diseases
- Surgical Outcomes
- Public Health
Background:
- The Omicron variant of SARS-CoV-2 presents unique challenges for healthcare systems.
- Understanding the impact of active Omicron infection on surgical patient safety is crucial for clinical decision-making.
Purpose of the Study:
- To evaluate the safety of undergoing surgery in patients with active Omicron variant infection.
- To determine if Omicron infection necessitates delaying elective surgical procedures.
Main Methods:
- A cohort of 3,661 surgical patients was analyzed, comparing 580 infected with 3,081 uninfected patients.
- Propensity score matching (PSM) was used to control for confounding variables.
- Multivariate logistic regression analyzed perioperative complications across different time intervals between Omicron infection and surgery (0-7, 8-14, 15-30, >30 days).
Main Results:
- No statistically significant increase in major perioperative complications was observed in patients with Omicron infection compared to uninfected patients.
- Specific complications like renal insufficiency (8-14 days post-infection) and anemia (>30 days post-infection) showed significant differences, but overall major complication rates remained comparable.
- Key outcomes including transfusion rates, ICU transfer, respiratory complications, sepsis, DVT, and hypoalbuminemia were not significantly affected by Omicron infection.
Conclusions:
- Omicron variant infection does not appear to be a significant risk factor for major perioperative complications.
- Elective surgery can likely proceed without postponement in patients with Omicron infection, based on current findings.
