Impact of the SARS-CoV-2 (COVID19) pandemic on the morbidity and mortality of high risk patients undergoing surgery: a non-inferiority retrospective observational study

Abstract Background During the COVID-19 crisis it was necessary to generate a specific care network and reconvert operating rooms to attend emergency and high-acuity patients undergoing complex surgery. The aim of this study is to classify postoperative complications and mortality and to assess the...

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Autores principales:	Marta Caballero-Milán, Maria J. Colomina, Leo A. Marin-Carcey, Laura Viguera-Fernandez, Roser Bayona-Domenge, Sara Garcia-Ballester, Albert López-Farre, Leticia Ruiz-Buera, Maite Sanz-Iturbe, David Álvarez-Villegas, Ely C. Jenssen-Paz, Guillermo Puig-Sanz, Aaron Arcos-Terrones, Carmen Belmonte-Cuenca, Elia Perelada-Alonso, Francho Blasco-Blasco, Antoni Sabaté
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Elective surgery Emergent surgery SARS-CoV-2 (COVID19) pandemic Clavien-Dindo complications Mortality Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/60fd457076a443dd8abbcc0ffa3064f8
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spelling	oai:doaj.org-article:60fd457076a443dd8abbcc0ffa3064f82021-11-28T12:09:47ZImpact of the SARS-CoV-2 (COVID19) pandemic on the morbidity and mortality of high risk patients undergoing surgery: a non-inferiority retrospective observational study10.1186/s12871-021-01495-31471-2253https://doaj.org/article/60fd457076a443dd8abbcc0ffa3064f82021-11-01T00:00:00Zhttps://doi.org/10.1186/s12871-021-01495-3https://doaj.org/toc/1471-2253Abstract Background During the COVID-19 crisis it was necessary to generate a specific care network and reconvert operating rooms to attend emergency and high-acuity patients undergoing complex surgery. The aim of this study is to classify postoperative complications and mortality and to assess the impact that the COVID-19 pandemic may have had on the results. Methods this is a non-inferiority retrospective observational study. Two different groups of surgical patients were created: Pre-pandemic COVID and Pandemic COVID. Severity of illness was rated according to the Diagnosis-related Groups (DRG) score. Comparisons were made between groups and between DRG severity score-matched samples. Non-inferiority was set at up to 10 % difference for grade III to V complications according to the Clavien-Dindo classification, and up to 2 % difference in mortality. Results A total of 1649 patients in the PreCOVID group and 763 patients in the COVID group were analysed; 371 patients were matched for DRG severity score 3-4 (236 preCOVID and 135 COVID). No differences were found in relation to re-operation (22.5 % vs. 21.5 %) or late admission to critical care unit (5.1 % vs. 4.5 %). Clavien grade III to V complications occurred in 107 patients (45.3 %) in the PreCOVID group and in 56 patients (41.5 %) in the COVID group, and mortality was 12.7 % and 12.6 %, respectively. During the pandemic, 3 % of patients tested positive for Covid-19 on PCR: 12 patients undergoing elective surgery and 11 emergency surgery; there were 5 deaths, 3 of which were due to respiratory failure following Covid-19-induced pneumonia. Conclusions Although this study has some limitations, it has shown the non-inferiority of surgical outcomes during the COVID pandemic, and indicates that resuming elective surgery is safe. Trial registration Clinicaltrials.gov identifier: NCT04780594 .Marta Caballero-MilánMaria J. ColominaLeo A. Marin-CarceyLaura Viguera-FernandezRoser Bayona-DomengeSara Garcia-BallesterAlbert López-FarreLeticia Ruiz-BueraMaite Sanz-IturbeDavid Álvarez-VillegasEly C. Jenssen-PazGuillermo Puig-SanzAaron Arcos-TerronesCarmen Belmonte-CuencaElia Perelada-AlonsoFrancho Blasco-BlascoAntoni SabatéBMCarticleElective surgeryEmergent surgerySARS-CoV-2 (COVID19) pandemicClavien-Dindo complicationsMortalityAnesthesiologyRD78.3-87.3ENBMC Anesthesiology, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Elective surgery Emergent surgery SARS-CoV-2 (COVID19) pandemic Clavien-Dindo complications Mortality Anesthesiology RD78.3-87.3
spellingShingle	Elective surgery Emergent surgery SARS-CoV-2 (COVID19) pandemic Clavien-Dindo complications Mortality Anesthesiology RD78.3-87.3 Marta Caballero-Milán Maria J. Colomina Leo A. Marin-Carcey Laura Viguera-Fernandez Roser Bayona-Domenge Sara Garcia-Ballester Albert López-Farre Leticia Ruiz-Buera Maite Sanz-Iturbe David Álvarez-Villegas Ely C. Jenssen-Paz Guillermo Puig-Sanz Aaron Arcos-Terrones Carmen Belmonte-Cuenca Elia Perelada-Alonso Francho Blasco-Blasco Antoni Sabaté Impact of the SARS-CoV-2 (COVID19) pandemic on the morbidity and mortality of high risk patients undergoing surgery: a non-inferiority retrospective observational study
description	Abstract Background During the COVID-19 crisis it was necessary to generate a specific care network and reconvert operating rooms to attend emergency and high-acuity patients undergoing complex surgery. The aim of this study is to classify postoperative complications and mortality and to assess the impact that the COVID-19 pandemic may have had on the results. Methods this is a non-inferiority retrospective observational study. Two different groups of surgical patients were created: Pre-pandemic COVID and Pandemic COVID. Severity of illness was rated according to the Diagnosis-related Groups (DRG) score. Comparisons were made between groups and between DRG severity score-matched samples. Non-inferiority was set at up to 10 % difference for grade III to V complications according to the Clavien-Dindo classification, and up to 2 % difference in mortality. Results A total of 1649 patients in the PreCOVID group and 763 patients in the COVID group were analysed; 371 patients were matched for DRG severity score 3-4 (236 preCOVID and 135 COVID). No differences were found in relation to re-operation (22.5 % vs. 21.5 %) or late admission to critical care unit (5.1 % vs. 4.5 %). Clavien grade III to V complications occurred in 107 patients (45.3 %) in the PreCOVID group and in 56 patients (41.5 %) in the COVID group, and mortality was 12.7 % and 12.6 %, respectively. During the pandemic, 3 % of patients tested positive for Covid-19 on PCR: 12 patients undergoing elective surgery and 11 emergency surgery; there were 5 deaths, 3 of which were due to respiratory failure following Covid-19-induced pneumonia. Conclusions Although this study has some limitations, it has shown the non-inferiority of surgical outcomes during the COVID pandemic, and indicates that resuming elective surgery is safe. Trial registration Clinicaltrials.gov identifier: NCT04780594 .
format	article
author	Marta Caballero-Milán Maria J. Colomina Leo A. Marin-Carcey Laura Viguera-Fernandez Roser Bayona-Domenge Sara Garcia-Ballester Albert López-Farre Leticia Ruiz-Buera Maite Sanz-Iturbe David Álvarez-Villegas Ely C. Jenssen-Paz Guillermo Puig-Sanz Aaron Arcos-Terrones Carmen Belmonte-Cuenca Elia Perelada-Alonso Francho Blasco-Blasco Antoni Sabaté
author_facet	Marta Caballero-Milán Maria J. Colomina Leo A. Marin-Carcey Laura Viguera-Fernandez Roser Bayona-Domenge Sara Garcia-Ballester Albert López-Farre Leticia Ruiz-Buera Maite Sanz-Iturbe David Álvarez-Villegas Ely C. Jenssen-Paz Guillermo Puig-Sanz Aaron Arcos-Terrones Carmen Belmonte-Cuenca Elia Perelada-Alonso Francho Blasco-Blasco Antoni Sabaté
author_sort	Marta Caballero-Milán
title	Impact of the SARS-CoV-2 (COVID19) pandemic on the morbidity and mortality of high risk patients undergoing surgery: a non-inferiority retrospective observational study
title_short	Impact of the SARS-CoV-2 (COVID19) pandemic on the morbidity and mortality of high risk patients undergoing surgery: a non-inferiority retrospective observational study
title_full	Impact of the SARS-CoV-2 (COVID19) pandemic on the morbidity and mortality of high risk patients undergoing surgery: a non-inferiority retrospective observational study
title_fullStr	Impact of the SARS-CoV-2 (COVID19) pandemic on the morbidity and mortality of high risk patients undergoing surgery: a non-inferiority retrospective observational study
title_full_unstemmed	Impact of the SARS-CoV-2 (COVID19) pandemic on the morbidity and mortality of high risk patients undergoing surgery: a non-inferiority retrospective observational study
title_sort	impact of the sars-cov-2 (covid19) pandemic on the morbidity and mortality of high risk patients undergoing surgery: a non-inferiority retrospective observational study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/60fd457076a443dd8abbcc0ffa3064f8
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Impact of the SARS-CoV-2 (COVID19) pandemic on the morbidity and mortality of high risk patients undergoing surgery: a non-inferiority retrospective observational study

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