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Effects of Preoperative COVID-19 Status on Emergent or Urgent Colectomy Outcomes.

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Area of Science:

  • Surgical outcomes research
  • Infectious disease epidemiology
  • Gastrointestinal surgery

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can trigger a robust immune response.
  • Patients with coronavirus disease 2019 (COVID-19) undergoing emergent or urgent colectomies may face heightened surgical complication risks.

Purpose of the Study:

  • To evaluate the impact of preoperative COVID-19 infection on clinical outcomes for patients undergoing nonelective colectomies.
  • To compare outcomes between COVID-19 positive (COVID+) and COVID-19 negative (COVID-) cohorts.

Main Methods:

  • Utilized the American College of Surgeons National Surgical Quality Improvement Program Targeted Colectomy database for colectomies performed in 2021.
  • Filtered for "Urgent" or "Emergent" colectomies, creating COVID+ (n=242) and COVID- (n=11,049) groups for comparison.

Main Results:

  • COVID+ patients were more likely to have undergone urgent/emergent colectomy (68.36% vs 25.05%) and used steroids preoperatively (21.49% vs 12.41%).
  • A higher percentage of COVID+ patients required reoperation (14.05% vs 8.13%), experienced prolonged hospital stays (>30 days) (18.18% vs 5.35%), and had higher mortality rates (14.05% vs 8.08%).
  • While associated with higher mortality, COVID-19 infection did not independently predict mortality (OR 1.25, P=0.233).

Conclusions:

  • Preoperative COVID-19 positivity in urgent/emergent colectomy patients is associated with increased comorbidities.
  • These comorbidities, combined with the recent viral infection, significantly worsen clinical outcomes, including a higher mortality rate.