Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

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dc.contributor.authorNepogodiev, D
dc.contributor.authorBhangu, A
dc.contributor.authorGlasbey, JC
dc.contributor.authorLi, E
dc.contributor.authorOmar, OM
dc.contributor.authorSimoes, JF
dc.contributor.authorAbbott, TE
dc.contributor.authorAlser, O
dc.contributor.authorArnaud, AP
dc.contributor.authorBankhead-Kendall, BK
dc.contributor.authorBreen, K
dc.contributor.authorCuhna, MF
dc.contributor.authorDavidson, GH
dc.contributor.authorSaverio, SD
dc.contributor.authorGallo, G
dc.contributor.authorGriffiths, EA
dc.contributor.authorGujjuri, RR
dc.contributor.authorHutchinson, PJ
dc.contributor.authorKaafarani, HM
dc.contributor.authorLederhuber, H
dc.contributor.authorLöffler, MW
dc.contributor.authorMashbari, HN
dc.contributor.authorMinaya-Bravo, A
dc.contributor.authorMorton, DG
dc.contributor.authorMoszkowicz, D
dc.contributor.authorPata, F
dc.contributor.authorTsoulfas, G
dc.contributor.authorVenn, ML
dc.contributor.authorCox, D
dc.contributor.authorRoslani, AC
dc.contributor.authorAlakoloko, FM
dc.contributor.authorVries, JP
dc.contributor.authorAaraj, MA
dc.contributor.authorAbbott, SJ
dc.contributor.authorAbdalla, MO
dc.contributor.authorAbdelaal, AS
dc.contributor.authorAdemuyiwa, AO
dc.contributor.authorAherne, TM
dc.date.accessioned2022-09-01T08:46:32Z
dc.date.available2022-09-01T08:46:32Z
dc.date.issued2020
dc.descriptionScholarly articleen_US
dc.description.abstractBackground: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28-2·40], p<0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65-3·22], p<0·0001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (2·35 [1·57-3·53], p<0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01-2·39], p=0·046), emergency versus elective surgery (1·67 [1·06-2·63], p=0·026), and major versus minor surgery (1·52 [1·01-2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery.en_US
dc.identifier.citationCOVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020 Jul 4;396(10243):27-38. doi: 10.1016/S0140-6736(20)31182-X. Epub 2020 May 29. Erratum in: Lancet. 2020 Jun 9;: PMID: 32479829; PMCID: PMC7259900.en_US
dc.identifier.urihttps://ir.unilag.edu.ng/handle/123456789/11208
dc.language.isoenen_US
dc.publisherElsevier Ltden_US
dc.subjectrespiratory syndrome coronavirus 2 (SARS-CoV-2)en_US
dc.subjectMortalityen_US
dc.subjectpulmonary complication ratesen_US
dc.subjectPatientsen_US
dc.subjectpneumoniaen_US
dc.subjectResearch Subject Categories::MEDICINE::Surgeryen_US
dc.titleMortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort studyen_US
dc.typeArticleen_US
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