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Changes in early postoperative outcomes and complications observed in a single center during the 2022 COVID-19 pandemic wave in China:A single-center ambispective cohort study

Changes in early postoperative outcomes and complications observed in a single center during the 2022 COVID-19 pandemic wave in China: A single-center ambispective cohort study

作     者:Lini Wang Ziyu Zheng Shouqiang Zhu Gang Luo Baobao Gao Yumei Ma Shuai Xu Hailong Dong Chong Lei Lini Wang;Ziyu Zheng;Shouqiang Zhu;Gang Luo;Baobao Gao;Yumei Ma;Shuai Xu;Hailong Dong;Chong Lei

作者机构:Department of Anesthesiology and Perioperative MedicineXijing HospitalFourth Military Medical UniversityXi’anShaanxi 710032China Anesthesia Clinical Research CenterXijing HospitalFourth Military Medical UniversityXi’anShaanxi 710032China 

出 版 物:《Chinese Medical Journal》 (中华医学杂志(英文版))

年 卷 期:2023年第136卷第14期

页      面:1708-1718页

核心收录:

学科分类:1002[医学-临床医学] 100210[医学-外科学(含:普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主  题:COVID-19 Decision-making Surgery Omicron Postoperative complications 

摘      要:Background:Currently,the effect of the 2022 nationwide coronavirus disease 2019(COVID-19)wave on the perioperative prognosis of surgical patients in China is ***,we aimed to explore its influence on postoperative morbidity and mortality in surgical ***:An ambispective cohort study was conducted at Xijing Hospital,*** collected 10-day time-series data from December 29 until January 7 for the 2018-2022 *** primary outcome was major postoperative complications(Clavien-Dindo class III-V).The association between COVID-19 exposure and postoperative prognosis was explored by comparing consecutive 5-year data at the population level and by comparing patients with and without COVID-19 exposure at the patient ***:The entire cohort consisted of 3350 patients(age:48.5±19.2 years),including 1759 females(52.5%).Overall,961(28.7%)underwent emergency surgery,and 553(16.5%)had COVID-19 exposure(from the 2022 cohort).At the population level,major postoperative complications occurred in 5.9%(42/707),5.7%(53/935),5.1%(46/901),9.4%(11/117),and 22.0%(152/690)patients in the 2018-2022 cohorts,*** adjusting for potential confounding factors,the 2022 cohort(80%patients with COVID-19 history)had a significantly higher postoperative major complication risk than did the 2018 cohort(adjusted risk difference[aRD],14.9%(95%confidence interval[CI],11.5-18.4%);adjusted odds ratio[aOR],8.19(95%CI,5.24-12.81)).At the patient level,the incidence of major postoperative complications was significantly greater in patients with(24.6%,136/553)than that in patients without COVID-19 history(6.0%[168/2797];aRD,17.8%[95%CI,13.6-22.1%];aOR,7.89[95%CI,5.76-10.83]).Secondary outcomes of postoperative pulmonary complications were consistent with primary *** findings were verified through sensitivity analyses using time-series data projections and propensity score ***:Based on a single-center observation,patients with recent COVID

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