Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0–2 weeks, 3–4 weeks and 5–6 weeks of the diagnosis (odds ratio (95%CI) 4.1% (3.3–4.8), 3.9% (2.6–5.1) and 3.6% (2.0–5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5% (0.9– 2.1%)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2–8.7) vs. 2.4% (95%CI 1.4–3.4) vs. 1.3% (95%CI 0.6–2.0%), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.

), Laura Alberici, F.A. (2021). Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study. ANAESTHESIA, 76(6), 748-758 [10.1111/anae.15458].

Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study

Laura Alberici;Filippo Antonacci;Alessandro Arena;Angela Belvedere;Paolo Bernante;Pietro Bertoglio;Lorenzo Bianchi;Maria Bisulli;Barbara Bonfanti;Safia Boussedra;Jury Brandolini;Crescenzo Cacciapuoti;Stefano Cardelli;Riccardo Casadei;Matteo Cescon;Alessandro Cipolli;Alfredo Conti;Luca Contu;Francesco Costa;Niccolo’ Daddi;Eugenia De Crescenzo;Pierandrea De Iaco;Massimo Del Gaudio;Anna Nunzia Della Gatta;Giampiero Dolci;Giulia Dondi;Matteo Droghetti;Chiara Gelati;Giuliana Germinario;Carlo Ingaldi;Elio Jovine;Antonio Lanci Lanci;Raffaele Lombardi;Maria Elisa Lozano Miralles;Claudio Marchetti;Francesco Minni;Daniele Morezzi;Daniele Parlanti;Alice Pellegrini;Anna Myriam Perrone;Anna paola Pezzuto;Marco Pignatti;Gianluigi Pilu;Valentina Pinto;Gilberto Poggioli;Diego Raimondo;Matteo Ravaioli;Claudio Ricci;Sara Ricciardi;Francesco Ricotta;Roberta Rizzo;Angela Romano;Matteo Rottoli;Riccardo Schiavina;Renato Seracchioli;Matteo Serenari;Margherita Serra;Mario Taffurelli;Marta Tanzanu;Achille Tarsitano;Marco Tesei;Gabriele Vago;Tommaso Violante;Tommaso Frisoni;leonardo solaini;giorgio ercolani
2021

Abstract

Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0–2 weeks, 3–4 weeks and 5–6 weeks of the diagnosis (odds ratio (95%CI) 4.1% (3.3–4.8), 3.9% (2.6–5.1) and 3.6% (2.0–5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5% (0.9– 2.1%)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2–8.7) vs. 2.4% (95%CI 1.4–3.4) vs. 1.3% (95%CI 0.6–2.0%), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.
2021
), Laura Alberici, F.A. (2021). Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study. ANAESTHESIA, 76(6), 748-758 [10.1111/anae.15458].
); Laura Alberici, Filippo Antonacci, Alessandro Arena, Angela Belvedere, Fabio Bernagozzi, Paolo Bernante, Pietro Bertoglio, Lorenzo Bianchi, Maria B...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/813770
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