术后COVID-19确实与接种疫苗的患者手术结果更差有关吗?
R Carramiñana-Nuño1, V Borrego-Estella2, G C Inaraja-Pérez3
1General and Digestive Surgery Department -, Hospital Clínico Universitario Lozano Blesa, Calle San Juan Bosco, 15, 50009, Saragossa, Spain. rubencarraminananuno@gmail.com.
Updates in surgery
|March 15, 2024
概括
在COVID-19后选择性手术推迟可能不适用于所有患者. 这项研究发现,与对照组相比,接种疫苗的COVID-19阳性手术患者的死亡率或并发症没有增加.
科学领域:
- 麻醉学 麻醉学
- 手术瘤学手术瘤学
- 传染性疾病 传染性疾病
背景情况:
- 由于COVID-19感染后的高并发症率,早期的流行病建议推迟选择性手术至少7周.
- 随着疫苗接种的增加,对这些建议进行重新评估至关重要,以确定影响COVID后手术发病率和死亡率的因素.
研究的目的:
- 评估术后COVID-19感染对30天术后死亡率和并发症的影响.
- 在接种疫苗的人口背景下,重新评估推迟选择性手术的必要性.
主要方法:
- 一个单一中心的病例控制研究将80名COVID-19阳性患者与80名接受相同手术的对照进行了匹配.
- 在2021年11月至2022年3月期间收集的数据.
- 主要结局:术后30天死亡率;次要结局:术后呼吸道和血栓栓塞并发症.
主要成果:
- 在COVID-19阳性患者和对照人群之间,30天死亡率 (7.5%与6.2%) 或术后并发症 (11.3%与8.9%) 没有显著差异.
- 在这两组中,接种疫苗率都很高 (88.8%对92.5%).
- 在COVID-19阳性患者中,死亡率与年龄>70,ASA分数>III,RCRI>1,紧急程序和缺乏预防有关.
结论:
- 经手术后的COVID-19感染并没有导致该队列的发病率或死亡率增加,这与之前的研究结果相反.
- 推迟选择性手术可能并不普遍需要,除了高风险个体.
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