与SARS-CoV-2感染后手术时间相关的术后结果
Ira L Leeds1,2, Lesley S Park3, Kathleen Akgun2,4
1Department of Surgery, Yale University School of Medicine, New Haven, CT.
Annals of surgery
|February 7, 2024
概括
在SARS-CoV-2感染后14天内进行手术与增加的死亡率和并发症有关. 在感染后的14天内推迟手术可能会减轻这些不良的外科结果.
科学领域:
- 传染性疾病 传染性疾病
- 外科手术的结果
- 公共卫生 公共卫生
背景情况:
- 以前的研究表明,COVID-19后的外科手术结果更差.
- 目前的指导方针通常建议在感染后七周推迟手术.
- 与SARS-CoV-2感染相关的手术时间的影响需要进一步调查.
研究的目的:
- 检查之前的SARS-CoV-2感染,感染到手术的间隔以及不良手术结果之间的关联.
- 为了确定感染后的特定时间间隔是否会增加手术风险.
- 根据SARS-CoV-2感染后手术时间的最新建议.
主要方法:
- 美国退伍军人卫生管理局患者的回顾性队列研究 (2020年4月-2022年9月).
- 分析包括82815名接受手术的患者,其中16563人先前感染了SARS-CoV-2.
- 通过多变量逻辑回归,从SARS-CoV-2阳性测试到手术的2周间隔对患者进行匹配和分析.
主要成果:
- 之前的SARS-CoV-2感染与90天死亡率 (OR 1.42) 和30天并发症 (OR 1.32) 的增加有关,仅用于感染后14天内的手术.
- 这些增加的风险主要在患有更高美国麻醉学会 (ASA) 评分 (4-5) 的患者中观察到.
- 在SARS-CoV-2感染后14天以上的手术中,不良结果没有显著增加.
结论:
- 在SARS-CoV-2检测阳性后14天内接受手术的患者面临更高的术后死亡和并发症风险.
- 这些发现表明,相对于SARS-CoV-2感染,手术的时间是关键因素.
- 在SARS-CoV-2感染后推迟手术的建议可能需要根据这些结果进行修订.
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