COVID-19 急诊腹部手术患者术后并发症的预测因素

Çağrı Büyükkasap, Mustafa Ünal Sayilir, Yunushan Furkan Aydoğdu, Aydın Yavuz, Hüseyin Göbüt, Kursat Dikmen
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摘要

目的:COVID-19 在全球的迅速传播也导致了手术患者术后并发症发生率的增加。显然,COVID-19 阳性可能会影响急诊手术患者的术后并发症。本研究旨在评估接受急诊腹部手术的 COVID-19 患者术后并发症的预测因素。材料与方法:对 52 例接受急诊腹部手术且在围手术期 72 小时内通过聚合酶链反应(PCR)检测发现 COVID-19 阳性的患者进行回顾性评估。结果研究对象的中位年龄为 50.5 岁(18-83 岁)。30 天死亡率为 15.4%,术后并发症发生率为 23.1%。研究发现,术后并发症状况与年龄(p = 0.003)、术后并发症状况与术前血红蛋白水平(p = 0.001)之间存在明显相关性。同时评估年龄和血红蛋白对术后并发症的敏感性为 91.7%,特异性为 87.5%(p < 0.001,AUC:0.867)。此外,还发现术前血红蛋白水平与住院时间呈负相关(p < 0.001)。结论接受急诊腹部手术的 COVID-19 阳性患者面临很大的术后并发症风险。高龄和低血红蛋白水平可能是这类患者术后并发症的预测因素。
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Predictors of Postoperative Complications in COVID-19 Patients Undergoing Emergency Abdominal Surgeries
Aim: The rapid spread of COVID-19 worldwide has also caused an increase in the incidence of postoperative complications in surgical patients. Clearly, COVID-19 positivity may affect postoperative complications in patients undergoing emergency surgeries. This study aimed to evaluate the factors predictive of postoperative complications in COVID-19 patients undergoing emergency abdominal surgeries. Material and Methods: Fifty-two patients who underwent emergency abdominal surgeries and were positive for COVID-19 via a Polymerase Chain Reaction (PCR) test within 72 h of the perioperative period were evaluated retrospectively. Results: The median age of the patients included in the study was 50.5 years (range: 18–83 years). The 30-day mortality rate was 15.4%, while the postoperative complication rate was 23.1%. A significant correlation was found between postoperative complication status and age (p = 0.003) and between postoperative complication status and preoperative hemoglobin levels (p = 0.001). The evaluation of age and hemoglobin together showed a sensitivity of 91.7% and a specificity of 87.5% for postoperative complications (p < 0.001, AUC: 0.867). In addition, a negative correlation was found between preoperative hemoglobin levels and length of hospital stay (p < 0.001). Conclusion: COVID-19-positive patients who undergo emergency abdominal surgeries face a significant risk of postoperative complications. An advanced age and low hemoglobin levels may be predictors of postoperative complications in this group of patients.
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