Surgery (Austin & Northern Health) - Research Publications
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ItemTiming of surgery following SARS-CoV-2 infection: an international prospective cohort studyNepogodiev, D ; Simoes, JFF ; Li, E ; Picciochi, M ; Glasbey, JC ; Baiocchi, G ; Blanco-Colino, R ; Chaudhry, D ; AlAmeer, E ; El-Boghdadly, K ; Wuraola, F ; Ghosh, D ; Gujjuri, RR ; Harrison, EM ; Lule, H ; Kaafarani, H ; Khosravi, M ; Kronberger, I ; Leventoglu, S ; Mann, H ; Mclean, KA ; Mengesha, MG ; Marta Modolo, M ; Ntirenganya, F ; Norman, L ; Outani, O ; Pius, R ; Pockney, P ; Qureshi, AU ; Roslani, AC ; Satoi, S ; Shaw, C ; Bhangu, A ; Omar, OM ; Ahmed, W-U-R ; Argus, L ; Ball, A ; Bywater, EP ; Blanco-Colino, R ; Brar, A ; Chaudhry, D ; Dawson, BE ; Duran, I ; Elhadi, M ; Glasbey, JC ; Gujjuri, RR ; Jones, CS ; Harrison, EM ; Kamarajah, SK ; Keatley, JM ; Lawday, S ; Mann, H ; Marson, EJ ; Mclean, KA ; Norman, L ; Ots, R ; Outani, O ; Picciochi, M ; Santos, I ; Shaw, C ; Taylor, EH ; Trout, IM ; Varghese, C ; Venn, ML ; Xu, W ; Dajti, I ; Gjata, A ; Kacimi, SEO ; Boccalatte, L ; Cox, D ; Pockney, P ; Townend, P ; Aigner, F ; Kronberger, IE ; Samadov, E ; Alderazi, A ; Hossain, K ; Padmore, G ; van Ramshorst, G ; Lawani, I ; Cerovac, A ; Delibegovic, S ; Baiocchi, G ; Ataide Gomes, GM ; Buarque, IL ; Gohar, M ; Slavchev, M ; Nwegbu, C ; Agarwal, A ; Brar, A ; Martin, J ; Ng-Kamstra, J ; Olivos, M ; Lou, W ; Ren, D-L ; Andres Calvache, J ; J-Perez Rivera, C ; Hadzibegovic, AD ; Kopjar, T ; Mihanovic, J ; Aviles Jimenez, PM ; Gouvas, N ; Klat, J ; Novysedlak, R ; Amisi, N ; Christensen, P ; El-Hussuna, A ; Batista, S ; Lincango-Naranjo, E ; Emile, S ; Arevalo Sandoval, DA ; Dhufera, H ; Hailu, S ; Mengesha, MG ; Kauppila, JH ; Arnaud, AP ; Demetrashvili, Z ; Albertsmeier, M ; Lederhuber, H ; Loeffler, MW ; Acquah, DK ; Ofori, B ; Tabiri, S ; Metallidis, S ; Tsoulfas, G ; Aguilera-Arevalo, M-L ; Recinos, G ; Mersich, T ; Wettstein, D ; Ghosh, D ; Kembuan, G ; Milan, PB ; Khosravi, MH ; Mozafari, M ; Hilmi, A ; Mohan, H ; Zmora, O ; Gallo, G ; Pata, F ; Pellino, G ; Fujimoto, Y ; Kuroda, N ; Satoi, S ; Abou Chaar, MK ; Ayasra, F ; Fakhradiyev, I ; Hamdun, IHS ; Jin-Young, J ; Jamal, M ; Karout, L ; Elhadi, M ; Gulla, A ; Rasoaherinomenjanahary, F ; Samison, LH ; Roslani, AC ; Duran Sanchez, II ; Samantha Gonzalez, D ; Martinez, L ; Jose Martinez, M ; Nayen, A ; Ramos-De la Medina, A (WILEY, 2021-03-09)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.