François Martin Carrier1,2,3, Éva Amzallag4, Vincent Lecluyse5,6, Geneviève Côté5,7, Étienne J Couture8,9, Frédérick D'Aragon10, Stanislas Kandelman11, Alexis F Turgeon8,12, Alain Deschamps5,13, Roy Nitulescu14, Codjo Djignefa Djade14, Martin Girard15,5,16,17, Pierre Beaulieu5,17, Philippe Richebé5,18. 1. Department of Anesthesiology & Department of Medicine - Critical Care Division, Centre hospitalier de l'Université de Montréal, 1000, rue St-Denis, Porte D04-5028, Montréal, Québec, H2X 3J4, Canada. francois.martin.carrier@umontreal.ca. 2. Carrefour de l'innovation et de l'évaluation en santé, Centre de recherche du CHUM, Montréal, Canada. francois.martin.carrier@umontreal.ca. 3. Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montréal, Canada. francois.martin.carrier@umontreal.ca. 4. Carrefour de l'innovation et de l'évaluation en santé, Centre de recherche du CHUM, Montréal, Canada. 5. Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montréal, Canada. 6. Department of Anesthesiology, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord de l'Île de Montréal, Montréal, Canada. 7. Department of Anesthesiology, Centre hospitalier Universitaire Sainte-Justine, Montréal, Canada. 8. Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Québec, Canada. 9. Department of Anesthesiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada. 10. Department of Anesthesiology, Université de Sherbrooke, Sherbrooke, Canada. 11. Department of Anesthesiology, McGill University Health Center, Montréal, Canada. 12. Department of Anesthesiology & Department of Medicine, Population Health and Optimal Health Practices Research Unit (Trauma - Emergency - Critical Care Medicine), CHU de Québec - Université Laval Research Center, Québec, Canada. 13. Department of Anesthesiology, Institut de cardiologie de Montréal, Université de Montréal, Montréal, Canada. 14. Centre d'intégration et d'analyse des données médicales, Centre de recherche du CHUM, Montréal, Canada. 15. Department of Anesthesiology & Department of Medicine - Critical Care Division, Centre hospitalier de l'Université de Montréal, 1000, rue St-Denis, Porte D04-5028, Montréal, Québec, H2X 3J4, Canada. 16. Imagerie et ingénierie, Centre de recherche du CHUM, Montréal, Canada. 17. Department of Anesthesiology, Centre hospitalier de l'Université de Montréal, Montréal, Canada. 18. Department of Anesthesiology, Hôpital Maisonneuve-Rosemont - CIUSSS de l'Est de l'île de Montréal, Montréal, Canada.
Abstract
BACKGROUND: Data on postoperative outcomes of the COVID-19 patient population is limited. We described COVID-19 patients who underwent a surgery and the pandemic impact on surgical activities. METHODS: We conducted a multicenter cohort study between March 13 and June 192,020. We included all COVID-19 patients who underwent surgery in nine centres of the Province of Québec, the Canadian province most afflicted by the pandemic. We also included concomitant suspected COVID-19 (subsequently confirmed not to have COVID-19) patients and patients who had recovered from it. We collected data on baseline characteristics, postoperative complications and postoperative mortality. Our primary outcome was 30-day mortality. We also collected data on overall surgical activities during this first wave and during the same period in 2019. RESULTS: We included 44 COVID-19 patients, 18 suspected patients, and 18 patients who had recovered from COVID-19 at time of surgery. Among the 44 COVID-19 patients, 31 surgeries (71%) were urgent and 16 (36%) were major. In these patients, pulmonary complications were frequent (25%) and 30-day mortality was high (15.9%). This mortality was higher in patients with symptoms (23.1%) compared to those without symptoms (5.6%), although not statistically significant (p = 0.118). Of the total 22,616 cases performed among participating centres during the study period, only 0.19% had COVID-19 at the time of surgery. Fewer procedures were performed during the study period compared to the same period in 2019 (44,486 cases). CONCLUSION: In this Canadian cohort study, postoperative 30-day mortality in COVID-19 patients undergoing surgery was high (15.9%). Although few surgeries were performed on COVID-19 patients, the pandemic impact on surgical activity volume was important. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04458337 .
BACKGROUND: Data on postoperative outcomes of the COVID-19patient population is limited. We described COVID-19patients who underwent a surgery and the pandemic impact on surgical activities. METHODS: We conducted a multicenter cohort study between March 13 and June 192,020. We included all COVID-19patients who underwent surgery in nine centres of the Province of Québec, the Canadian province most afflicted by the pandemic. We also included concomitant suspected COVID-19 (subsequently confirmed not to have COVID-19) patients and patients who had recovered from it. We collected data on baseline characteristics, postoperative complications and postoperative mortality. Our primary outcome was 30-day mortality. We also collected data on overall surgical activities during this first wave and during the same period in 2019. RESULTS: We included 44 COVID-19patients, 18 suspected patients, and 18 patients who had recovered from COVID-19 at time of surgery. Among the 44 COVID-19patients, 31 surgeries (71%) were urgent and 16 (36%) were major. In these patients, pulmonary complications were frequent (25%) and 30-day mortality was high (15.9%). This mortality was higher in patients with symptoms (23.1%) compared to those without symptoms (5.6%), although not statistically significant (p = 0.118). Of the total 22,616 cases performed among participating centres during the study period, only 0.19% had COVID-19 at the time of surgery. Fewer procedures were performed during the study period compared to the same period in 2019 (44,486 cases). CONCLUSION: In this Canadian cohort study, postoperative 30-day mortality in COVID-19patients undergoing surgery was high (15.9%). Although few surgeries were performed on COVID-19patients, the pandemic impact on surgical activity volume was important. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04458337 .
Entities:
Keywords:
COVID-19; Health system impact; Pandemic; Postoperative mortality; Postoperative outcomes; Surgery
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