COVID-19 patients who undergo surgery are at increased risk
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Patients undergoing surgery after contracting coronavirus are at greatly increased risk of postoperative death, a new global study published in The Lancet reveals. Researchers found that amongst SARS-CoV-2 infected patients who underwent surgery, mortality rates approach those of the sickest patients admitted to intensive care after contracting the virus in the community.

Researchers examined data for 1,128 patients from 235 hospitals. A total of 24 countries participated, predominantly in Europe. Overall 30-day mortality in the study was 23.8%:

- Mortality was disproportionately high across all subgroups, including elective surgery (18.9%), emergency surgery (25.6%), minor surgery such as appendicectomy or hernia repair (16.3%), and major surgery such as hip surgery or colon cancer surgery (26.9%).
- Mortality rates were higher in men - (28.4%) versus women (18.2%), and in patients aged 70 years or over (33.7%) versus those aged under 70 years (13.9%).
- In addition to age and sex, risk factors for postoperative death included having severe pre-existing medical problems, undergoing cancer surgery, undergoing major procedures, and undergoing emergency surgery.
- Overall in the 30 days following surgery 51% of patients developed a pneumonia, acute respiratory distress syndrome, or required unexpected ventilation.
- This may explain the high mortality, as most (81.7%) patients who died had experienced pulmonary complications.

These mortality rates are greater than those reported for even the highest-risk patients before the pandemic. This data suggests that it was the right decision to postpone operations at a time when patients were at risk of being infected with SARS-CoV-2 in hospital. But there’s now an urgent need for investment by governments and health providers in to measures which ensure that as surgery restarts patient safety is prioritised.

Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31182-X/fulltext
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