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术前COVID-19状态对紧急或紧急大肠切除术结果的影响

Satyam K Ghodasara¹, Grace C Chang¹, Justin S Roskam¹

¹From the Department of Surgery, Morristown Medical Center, Morristown, New Jersey.

Southern medical journal

|May 3, 2024

概括

手术前COVID-19感染患者接受紧急切除术的结果更糟. 这包括更高的并发症率和增加的死亡率,与伴随性疾病和病毒感染本身有关.

科学领域:

手术成果研究的研究结果.
传染病流行病学传染病流行病学
胃肠道手术胃肠道手术

背景情况:

严重急性呼吸道综合征冠状病毒2 (SARS-CoV-2) 感染可以引发强烈的免疫反应.
患有2019年新冠病毒病 (COVID-19) 患者接受紧急或紧急切除术可能面临更高的外科并发症风险.

研究的目的:

评估手术前COVID-19感染对接受非选择性切除术的患者临床结果的影响.
为了比较COVID-19阳性 (COVID+) 和COVID-19阴性 (COVID-) 队列之间的结果.

主要方法:

利用了美国外科医生学院国家外科质量改善计划针对性切除术数据库,用于2021年进行的切除术.
过以"紧急"或"紧急"的切除术,创建COVID+ (n=242) 和COVID- (n=11,049) 组进行比较.

主要成果:

COVID+患者更有可能接受紧急/紧急切除术 (68.36%与25.05%) 并使用类固醇进行手术前 (21.49%与12.41%).
更多的COVID+患者需要重新手术 (14.05%与8.13%),经历了长时间住院 (>30天) (18.18%与5.35%),死亡率更高 (14.05%与8.08%).
虽然与较高的死亡率有关,但COVID-19感染并不能独立预测死亡率 (OR 1.25,P=0.233).

结论:

在紧急/紧急切除术患者的手术前COVID-19阳性与伴随性疾病的增加有关.
这些并发症,结合最近的病毒感染,显著恶化临床结果,包括更高的死亡率.

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