与匹配的对照人群相比,COVID-19康复患者的术后死亡率:一个多中心的回顾性队列研究
Michael F Aziz1, Katie Schenning1, Seiji Koike2
1Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon.
Anesthesiology
|October 16, 2023
概括
之前患有COVID-19感染的患者在选择性手术后面临30天死亡率和肺部并发症的风险更高. 如果手术延迟超过感染后两周,这些风险会显著降低.
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:
- 以前的研究表明,近期COVID-19感染的手术患者的死亡风险增加.
- 由于这些风险,在COVID-19感染后,选择性手术通常会被推迟.
研究的目的:
- 为了比较30天的医院死亡率和手术后并发症 (急性损伤,肺部并发症) 在手术患者之前的COVID-19感染与匹配的对照组.
- 调查COVID-19暴露与手术患者死亡风险增加之间的关联.
主要方法:
- 选择性住院手术患者的回顾性观察队列研究 (2020年4月-2021年4月).
- 患者之前的COVID-19测试 (病例) 呈阳性,与那些负面或没有已知的阳性测试 (对照) 患者的比较.
- 根据人体测量数据,机构,并发症和根据从阳性测试到手术的时间分层分析进行匹配.
主要成果:
- 与对照组 (2.5%) 相比,COVID-19暴露患者的三十天死亡率更高 (4.6%).
- 暴露患者 (14%) 和对照组 (10%) 观察到肺部并发症的风险增加.
- 暴露患者 (9.5%) 和对照组 (8.6%) 之间急性损伤率没有显著差异.
结论:
- 之前的COVID-19感染与增加的外科手术期间死亡率和选择性手术的肺部并发症风险有关.
- 死亡和肺部并发症的风险在两周后从阳性COVID-19测试显著下降.
- 急性损伤风险与之前的COVID-19感染没有显著关联.
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