Recent COVID-19 infection is associated with increased mortality in the ambulatory surgery population - 05/07/23
, Talha Mubashir, MD b, Julius Balogh, MD b, Mohsen Rezapour, PhD c, Jingfan Hu, MS c, Biai Dominique, MS c, Nischal K. Gautam, MBBS a, Hongyin Lai, MS c, Hunza S. Ahmad, MD a, Xiaojin Li, PhD d, Yan Huang, PhD d, Guo-Qiang Zhang, MS PhD d, Vahed Maroufy, PhD c, ⁎⁎
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Abstract |
Background |
The effect of COVID-19 infection on post-operative mortality and the optimal timing to perform ambulatory surgery from diagnosis date remains unclear in this population. Our study was to determine whether a history of COVID-19 diagnosis leads to a higher risk of all-cause mortality following ambulatory surgery.
Methods |
This cohort constitutes retrospective data obtained from the Optum dataset containing 44,976 US adults who were tested for COVID-19 up to 6 months before surgery and underwent ambulatory surgery between March 2020 to March 2021. The primary outcome was the risk of all-cause mortality between the COVID-19 positive and negative patients grouped according to the time interval from COVID-19 testing to ambulatory surgery, called the Testing to Surgery Interval Mortality (TSIM) of up to 6 months. Secondary outcome included determining all-cause mortality (TSIM) in time intervals of 0–15 days, 16–30 days, 31–45 days, and 46–180 days in COVID-19 positive and negative patients.
Results |
44,934 patients (4297 COVID-19 positive, 40,637 COVID-19 negative) were included in our analysis. COVID-19 positive patients undergoing ambulatory surgery had higher risk of all-cause mortality compared to COVID-19 negative patients (OR = 2.51, p < 0.001). The increased risk of mortality in COVID-19 positive patients remained high amongst patients who had surgery 0–45 days from date of COVID-19 testing. In addition, COVID-19 positive patients who underwent colonoscopy (OR = 0.21, p = 0.01) and plastic and orthopedic surgery (OR = 0.27, p = 0.01) had lower mortality than those underwent other surgeries.
Conclusions |
A COVID-19 positive diagnosis is associated with significantly higher risk of all-cause mortality following ambulatory surgery. This mortality risk is greatest in patients that undergo ambulatory surgery within 45 days of testing positive for COVID-19. Postponing elective ambulatory surgeries in patients that test positive for COVID-19 infection within 45 days of surgery date should be considered, although prospective studies are needed to assess this.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Positive testing for COVID-19 is associated with a higher risk of all-cause mortality following ambulatory surgery. |
• | This mortality risk is greatest in patients that undergo ambulatory surgery within 45 days of testing positive for COVID-19. |
• | Postponing ambulatory surgeries in patients testing positive for COVID-19 within 45 days of surgery date should be considered. |
Keywords : COVID-19, Ambulatory surgery, Optum dataset, Testing to Surgery Interval Mortality (TSIM)
Plan
Vol 89
Article 111182- octobre 2023 Retour au numéro
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