The impact of preoperative coronavirus disease 19 infection on early postoperative mortality during the vaccination era: a nationwide retrospective cohort study
Background We aimed to investigate the optimal surgical timing in patients with preoperative coronavirus disease 2019 (COVID-19) infection to minimize postoperative morbidity and mortality during the COVID-19 vaccination era. Methods The Korean nationwide data on patients who underwent standard surg...
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2024-04-01
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| Series: | Korean Journal of Anesthesiology |
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| Online Access: | http://ekja.org/upload/pdf/kja-23761.pdf |
| _version_ | 1827302582942433280 |
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| author | Jae-Woo Ju Taeyup Kim Soo-Hyuk Yoon Won Ho Kim Ho-Jin Lee |
| author_facet | Jae-Woo Ju Taeyup Kim Soo-Hyuk Yoon Won Ho Kim Ho-Jin Lee |
| author_sort | Jae-Woo Ju |
| collection | DOAJ |
| description | Background We aimed to investigate the optimal surgical timing in patients with preoperative coronavirus disease 2019 (COVID-19) infection to minimize postoperative morbidity and mortality during the COVID-19 vaccination era. Methods The Korean nationwide data on patients who underwent standard surgery under general anesthesia in 2021 were analyzed. Patients were categorized based on the time from COVID-19 diagnosis to surgery: 0–4, 5–8, > 8 weeks, and those without preoperative COVID-19 infection. Multivariable logistic regression analysis, considering preoperative COVID-19 vaccination status (fully vaccinated vs. unvaccinated or partially vaccinated), was performed to associate the preoperative COVID-19 infection timing with 30- and 90-day postoperative mortality and 30-day respiratory complications. Results Among the 750,175 included patients, 28.2% were preoperatively fully vaccinated. Compared with patients without prior COVID-19 infection, those who had surgery 0–4 weeks (adjusted odds ratio [OR]: 4.28, 95% CI [1.81, 10.13], P = 0.001) and 5–8 weeks (adjusted OR: 3.38, 95% CI [1.54, 7.44], P = 0.002) after COVID-19 infection had a significantly increased risk of 30-day mortality. Preoperative full vaccination was significantly associated with a decrease in 90-day mortality (adjusted OR: 0.93, 95% CI [0.89, 0.98], P = 0.007) and 30-day respiratory complications (adjusted OR: 0.85, 95% CI [0.82, 0.87], P < 0.001), but not with 30-day mortality (P = 0.916). Conclusions COVID-19 infection eight weeks preoperatively was associated with an increased 30-day postoperative mortality. Preoperative full vaccination was not associated with 30-day mortality but was related to lower risk of 90-day mortality and 30-day respiratory complications. |
| first_indexed | 2024-04-24T16:46:41Z |
| format | Article |
| id | doaj.art-ca456962a936467cbf7c1bb43af6883e |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-04-24T16:46:41Z |
| publishDate | 2024-04-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-ca456962a936467cbf7c1bb43af6883e2024-03-29T07:56:40ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632024-04-0177218519410.4097/kja.237618959The impact of preoperative coronavirus disease 19 infection on early postoperative mortality during the vaccination era: a nationwide retrospective cohort studyJae-Woo Ju0Taeyup Kim1Soo-Hyuk Yoon2Won Ho Kim3Ho-Jin Lee4 Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, KoreaBackground We aimed to investigate the optimal surgical timing in patients with preoperative coronavirus disease 2019 (COVID-19) infection to minimize postoperative morbidity and mortality during the COVID-19 vaccination era. Methods The Korean nationwide data on patients who underwent standard surgery under general anesthesia in 2021 were analyzed. Patients were categorized based on the time from COVID-19 diagnosis to surgery: 0–4, 5–8, > 8 weeks, and those without preoperative COVID-19 infection. Multivariable logistic regression analysis, considering preoperative COVID-19 vaccination status (fully vaccinated vs. unvaccinated or partially vaccinated), was performed to associate the preoperative COVID-19 infection timing with 30- and 90-day postoperative mortality and 30-day respiratory complications. Results Among the 750,175 included patients, 28.2% were preoperatively fully vaccinated. Compared with patients without prior COVID-19 infection, those who had surgery 0–4 weeks (adjusted odds ratio [OR]: 4.28, 95% CI [1.81, 10.13], P = 0.001) and 5–8 weeks (adjusted OR: 3.38, 95% CI [1.54, 7.44], P = 0.002) after COVID-19 infection had a significantly increased risk of 30-day mortality. Preoperative full vaccination was significantly associated with a decrease in 90-day mortality (adjusted OR: 0.93, 95% CI [0.89, 0.98], P = 0.007) and 30-day respiratory complications (adjusted OR: 0.85, 95% CI [0.82, 0.87], P < 0.001), but not with 30-day mortality (P = 0.916). Conclusions COVID-19 infection eight weeks preoperatively was associated with an increased 30-day postoperative mortality. Preoperative full vaccination was not associated with 30-day mortality but was related to lower risk of 90-day mortality and 30-day respiratory complications.http://ekja.org/upload/pdf/kja-23761.pdfanesthesiacovid-19mortalitypostoperative complicationspreoperative periodsurgeryvaccination |
| spellingShingle | Jae-Woo Ju Taeyup Kim Soo-Hyuk Yoon Won Ho Kim Ho-Jin Lee The impact of preoperative coronavirus disease 19 infection on early postoperative mortality during the vaccination era: a nationwide retrospective cohort study Korean Journal of Anesthesiology anesthesia covid-19 mortality postoperative complications preoperative period surgery vaccination |
| title | The impact of preoperative coronavirus disease 19 infection on early postoperative mortality during the vaccination era: a nationwide retrospective cohort study |
| title_full | The impact of preoperative coronavirus disease 19 infection on early postoperative mortality during the vaccination era: a nationwide retrospective cohort study |
| title_fullStr | The impact of preoperative coronavirus disease 19 infection on early postoperative mortality during the vaccination era: a nationwide retrospective cohort study |
| title_full_unstemmed | The impact of preoperative coronavirus disease 19 infection on early postoperative mortality during the vaccination era: a nationwide retrospective cohort study |
| title_short | The impact of preoperative coronavirus disease 19 infection on early postoperative mortality during the vaccination era: a nationwide retrospective cohort study |
| title_sort | impact of preoperative coronavirus disease 19 infection on early postoperative mortality during the vaccination era a nationwide retrospective cohort study |
| topic | anesthesia covid-19 mortality postoperative complications preoperative period surgery vaccination |
| url | http://ekja.org/upload/pdf/kja-23761.pdf |
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