最近的COVID-19感染与门诊手术患者的死亡率增加有关
George W Williams1, Talha Mubashir2, Julius Balogh2
1Department of Anesthesiology and Critical Care, McGovern Medical School, University of Texas Health Science Center at Houston (UT Health), Houston, TX, United States.
Journal of clinical anesthesia
|July 2, 2023
概括
阳性COVID-19患者在门诊手术后面临的死亡风险明显更高. 当手术发生在COVID-19阳性测试后45天内时,这种风险最高,这表明需要谨慎地选择时间. 关键词:COVID-19,门诊手术,死亡风险,手术时间.
科学领域:
- 医学研究 医学研究
- 外科手术的结果
- 传染病流行病学 传染病流行病学
背景情况:
- 尚不清楚COVID-19对外科手术后术后死亡率的影响.
- 在COVID-19诊断后,最佳的外科手术时间需要进一步调查.
- 这项研究检查了前COVID-19诊断和门诊手术患者的死亡风险之间的关联.
研究的目的:
- 为了确定COVID-19诊断史是否会增加在门诊手术后因任何原因死亡的风险.
- 分析COVID-19诊断和手术之间的时间间隔对死亡率的影响.
- 确定与COVID-19阳性患者不同死亡风险相关的特定外科手术程序.
主要方法:
- 从Optum数据集 (2020年3月至2021年3月) 中对44976名美国成年人的回顾性分析.
- 包括在门诊手术前6个月内测试COVID-19的患者.
- 主要结果:根据COVID-19状态和手术间隔死亡率 (TSIM) 的测试分层的全因死亡风险.
主要成果:
- 与COVID-19阴性患者相比,COVID-19阳性患者的全因死亡风险增加了2.51倍 (p < 0.001).
- 在检测后45天内接受手术的COVID-19阳性患者中,死亡风险持续升高.
- 结肠镜和整形外科手术显示COVID-19阳性患者的死亡风险较低 (分别为OR=0.21,p=0.01和OR=0.27,p=0.01).
结论:
- 阳性COVID-19诊断与门诊手术后所有原因死亡率显著增加有关.
- 当在COVID-19检测结果阳性后45天内进行门诊手术时,死亡风险最大.
- 应考虑在COVID-19诊断后至少45天推迟选择性门诊手术,等待进一步的前性研究.
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