Mitigating the risks of surgery during the COVID-19 pandemic

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Mitigating the risks of surgery during the COVID-19 pandemic

JournalLancet
Publication date – May – 2020
Authors – Paul S Mylesa and Salome Maswime
Keywordscovid-19, global surgery
Open access – Yes
SpecialityEmergency surgery, Other
World region Global

Language – English
Submitted to the One Surgery Index on June 8, 2020 at 1:12 am
Abstract:

In response to the evolving COVID-19 pandemic, most governments and professional bodies recommended cancellation of elective surgery. This action was important to free up hospital bed capacity and ensure supplies of personal protective equipment (PPE), as well as to protect patients and health-care workers. In The Lancet, The COVIDSurg Collaborative1 report 30-day results of an international cohort study assessing postoperative outcomes in 1128 adults with COVID-19 who were undergoing a broad range of surgeries (605 [53·6%] men and 523 [46·4%] women; 214 [19·0%] aged <50 years, 353 [31·3%] aged 50–69 years, and 558 [49·5%] aged ≥70 years). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was diagnosed postoperatively in more than two-thirds of the patients (806 [71·5%]). The primary outcome was overall postoperative mortality at 30 days and the rate was high at 23·8% (268 of 1128 patients). Pulmonary complications occurred in 577 (51·2%) patients and 30-day mortality in these patients was 38·0% (219 of 577), accounting for 82·6% (219 of 265) of all deaths. Risk factors for mortality were patient age of 70 years or older, male sex, poor preoperative physical health status, emergency versus elective surgery, malignant versus benign or obstetric diagnosis, and more extensive (major vs minor) surgery. The high proportion of these patients who were diagnosed with SARS-CoV-2 infection in the postoperative period is of interest. These patients probably acquired their infection before being admitted to hospital, thus reflecting the high prevalence of SARS-CoV-2 in the community.

OSI Number – 20517
PMID – PMID: 32479826

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