Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defi...

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Detalles Bibliográficos
Autores: COVIDSurg Collaborative; GlobalSurg Collaborative, Mateo Sierra, Olga
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/128477
Acceso en línea:https://hdl.handle.net/20.500.14352/128477
Access Level:acceso abierto
Palabra clave:617
COVID-19
SARS-Cov-2
pathways
pre-operative isolation
surgery.
Ciencias Biomédicas
32 Ciencias Médicas
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oai_identifier_str oai:docta.ucm.es:20.500.14352/128477
network_acronym_str ES
network_name_str España
repository_id_str
spelling Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort studyCOVIDSurg Collaborative; GlobalSurg CollaborativeMateo Sierra, Olga617COVID-19SARS-Cov-2pathwayspre-operative isolationsurgery.Ciencias Biomédicas32 Ciencias MédicasWe aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05-1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4-7 days or ≥ 8 days of 1.25 (1.04-1.48), p = 0.015 and 1.31 (1.11-1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care.WileyUniversidad Complutense de Madrid20212021-11-0120212021-11-01journal articlehttp://purl.org/coar/resource_type/c_6501CVoRhttp://purl.org/coar/version/c_e19f295774971610info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.14352/128477reponame:Docta Complutenseinstname:Universidad Complutense de Madrid (UCM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:docta.ucm.es:20.500.14352/1284772026-06-02T12:44:21Z
dc.title.none.fl_str_mv Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study
title Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study
spellingShingle Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study
COVIDSurg Collaborative; GlobalSurg Collaborative
617
COVID-19
SARS-Cov-2
pathways
pre-operative isolation
surgery.
Ciencias Biomédicas
32 Ciencias Médicas
title_short Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study
title_full Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study
title_fullStr Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study
title_full_unstemmed Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study
title_sort Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study
dc.creator.none.fl_str_mv COVIDSurg Collaborative; GlobalSurg Collaborative
Mateo Sierra, Olga
author COVIDSurg Collaborative; GlobalSurg Collaborative
author_facet COVIDSurg Collaborative; GlobalSurg Collaborative
Mateo Sierra, Olga
author_role author
author2 Mateo Sierra, Olga
author2_role author
dc.contributor.none.fl_str_mv Universidad Complutense de Madrid
dc.subject.none.fl_str_mv 617
COVID-19
SARS-Cov-2
pathways
pre-operative isolation
surgery.
Ciencias Biomédicas
32 Ciencias Médicas
topic 617
COVID-19
SARS-Cov-2
pathways
pre-operative isolation
surgery.
Ciencias Biomédicas
32 Ciencias Médicas
description We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05-1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4-7 days or ≥ 8 days of 1.25 (1.04-1.48), p = 0.015 and 1.31 (1.11-1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021-11-01
2021
2021-11-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
CVoR
http://purl.org/coar/version/c_e19f295774971610
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.14352/128477
url https://hdl.handle.net/20.500.14352/128477
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
dc.source.none.fl_str_mv reponame:Docta Complutense
instname:Universidad Complutense de Madrid (UCM)
instname_str Universidad Complutense de Madrid (UCM)
reponame_str Docta Complutense
collection Docta Complutense
repository.name.fl_str_mv
repository.mail.fl_str_mv
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