The impact of preoperative coronavirus disease 19 infection on early postoperative mortality during the vaccination era: a nationwide retrospective cohort study.

IF 4.2 4区 医学 Q1 ANESTHESIOLOGY Korean Journal of Anesthesiology Pub Date : 2024-04-01 Epub Date: 2024-01-26 DOI:10.4097/kja.23761
Jae-Woo Ju, Taeyup Kim, Soo-Hyuk Yoon, Won Ho Kim, Ho-Jin Lee
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Abstract

Background: We aimed to investigate the optimal surgical timing in patients with preoperative coronavirus disease 2019 (COVID-19) infection to minimize postoperative morbidity and mortality during the COVID-19 vaccination era.

Methods: The Korean nationwide data on patients who underwent standard surgery under general anesthesia in 2021 were analyzed. Patients were categorized based on the time from COVID-19 diagnosis to surgery: 0-4, 5-8, > 8 weeks, and those without preoperative COVID-19 infection. Multivariable logistic regression analysis, considering preoperative COVID-19 vaccination status (fully vaccinated vs. unvaccinated or partially vaccinated), was performed to associate the preoperative COVID-19 infection timing with 30- and 90-day postoperative mortality and 30-day respiratory complications.

Results: Among the 750,175 included patients, 28.2% were preoperatively fully vaccinated. Compared with patients without prior COVID-19 infection, those who had surgery 0-4 weeks (adjusted odds ratio [OR]: 4.28, 95% CI [1.81, 10.13], P = 0.001) and 5-8 weeks (adjusted OR: 3.38, 95% CI [1.54, 7.44], P = 0.002) after COVID-19 infection had a significantly increased risk of 30-day mortality. Preoperative full vaccination was significantly associated with a decrease in 90-day mortality (adjusted OR: 0.93, 95% CI [0.89, 0.98], P = 0.007) and 30-day respiratory complications (adjusted OR: 0.85, 95% CI [0.82, 0.87], P < 0.001), but not with 30-day mortality (P = 0.916).

Conclusions: COVID-19 infection eight weeks preoperatively was associated with an increased 30-day postoperative mortality. Preoperative full vaccination was not associated with 30-day mortality but was related to lower risk of 90-day mortality and 30-day respiratory complications.

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疫苗接种时代,术前冠状病毒疾病 19 感染对术后早期死亡率的影响:一项全国范围的回顾性队列研究。
背景:我们旨在研究术前感染冠状病毒病2019(COVID-19)的患者的最佳手术时机,以便在COVID-19疫苗接种时代将术后发病率和死亡率降至最低:方法:分析了 2021 年在全身麻醉下接受标准手术的韩国全国患者数据。根据从 COVID-19 诊断到手术的时间对患者进行分类:0-4周、5-8周、>8周,以及术前无COVID-19感染的患者。考虑到术前 COVID-19 疫苗接种情况(完全接种与未接种或部分接种),我们进行了多变量逻辑回归分析,将术前 COVID-19 感染时间与术后 30 天和 90 天死亡率及 30 天呼吸道并发症联系起来:在纳入的 750,175 例患者中,28.2% 的患者在术前完全接种了疫苗。与之前未感染 COVID-19 的患者相比,在感染 COVID-19 后 0-4 周(调整后比值比 [OR],4.28;95% CI,1.81-10.13;P = 0.001)和 5-8 周(调整后比值比 [OR],3.38;95% CI,1.54-7.44;P = 0.002)进行手术的患者 30 天死亡风险显著增加。术前全程接种疫苗与90天死亡率(调整后OR值为0.93;95% CI为0.89-0.98;P = 0.007)和30天呼吸道并发症(调整后OR值为0.85;95% CI为0.82-0.87;P < 0.001)的降低有明显关系,但与30天死亡率无关(P = 0.916):结论:术前八周感染 COVID-19 与术后 30 天死亡率增加有关。结论:术前八周感染 COVID-19 与术后 30 天死亡率增加有关。术前全程接种疫苗与 30 天死亡率无关,但与 90 天死亡率和 30 天呼吸道并发症风险降低有关。
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来源期刊
CiteScore
6.20
自引率
6.90%
发文量
84
审稿时长
16 weeks
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