Outcomes after emergency abdominal surgery in COVID-19 patients at a referral center in Brazil
Purpose COVID-19 is associated with high morbidity and mortality in patients undergoing surgery. Contrary to elective procedures, emergency operations should not be postponed. We aim to evaluate the profile and outcomes of COVID-19 patients who underwent emergency abdominal surgery. Methods We perfo...
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| Published in: | Updates in surgery Vol. 73; no. 2; pp. 763 - 768 |
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| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Cham
Springer International Publishing
01-04-2021
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| Abstract | Purpose
COVID-19 is associated with high morbidity and mortality in patients undergoing surgery. Contrary to elective procedures, emergency operations should not be postponed. We aim to evaluate the profile and outcomes of COVID-19 patients who underwent emergency abdominal surgery.
Methods
We performed a retrospective analysis of perioperative data of COVID-19 patients undergoing emergency surgery from April 2020 to August 2020.
Results
Eighty-two patients were evaluated due to abdominal complaints, yielding 22 emergency surgeries. The mean APACHE II and SAPS were 18.7 and 68, respectively. Six patients had a PaO
2
/FiO
2
lower than 200 and more than 50% of parenchymal compromise on chest tomography.
The most common indications for emergency surgery were hernias (6; 27.2%). The median length of stay was 30 days, and only two patients required reoperation. Postoperatively, 10 (43.3%) patients needed mechanical ventilation for a mean of 6 days. The overall mortality rate was 31.8%.
Conclusion
Both postoperative morbidity and mortality are high in COVID-19 patients with respiratory compromise and abdominal emergencies. |
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| AbstractList | Purpose
COVID-19 is associated with high morbidity and mortality in patients undergoing surgery. Contrary to elective procedures, emergency operations should not be postponed. We aim to evaluate the profile and outcomes of COVID-19 patients who underwent emergency abdominal surgery.
Methods
We performed a retrospective analysis of perioperative data of COVID-19 patients undergoing emergency surgery from April 2020 to August 2020.
Results
Eighty-two patients were evaluated due to abdominal complaints, yielding 22 emergency surgeries. The mean APACHE II and SAPS were 18.7 and 68, respectively. Six patients had a PaO
2
/FiO
2
lower than 200 and more than 50% of parenchymal compromise on chest tomography.
The most common indications for emergency surgery were hernias (6; 27.2%). The median length of stay was 30 days, and only two patients required reoperation. Postoperatively, 10 (43.3%) patients needed mechanical ventilation for a mean of 6 days. The overall mortality rate was 31.8%.
Conclusion
Both postoperative morbidity and mortality are high in COVID-19 patients with respiratory compromise and abdominal emergencies. PURPOSECOVID-19 is associated with high morbidity and mortality in patients undergoing surgery. Contrary to elective procedures, emergency operations should not be postponed. We aim to evaluate the profile and outcomes of COVID-19 patients who underwent emergency abdominal surgery. METHODSWe performed a retrospective analysis of perioperative data of COVID-19 patients undergoing emergency surgery from April 2020 to August 2020. RESULTSEighty-two patients were evaluated due to abdominal complaints, yielding 22 emergency surgeries. The mean APACHE II and SAPS were 18.7 and 68, respectively. Six patients had a PaO2/FiO2 lower than 200 and more than 50% of parenchymal compromise on chest tomography. The most common indications for emergency surgery were hernias (6; 27.2%). The median length of stay was 30 days, and only two patients required reoperation. Postoperatively, 10 (43.3%) patients needed mechanical ventilation for a mean of 6 days. The overall mortality rate was 31.8%. CONCLUSIONBoth postoperative morbidity and mortality are high in COVID-19 patients with respiratory compromise and abdominal emergencies. COVID-19 is associated with high morbidity and mortality in patients undergoing surgery. Contrary to elective procedures, emergency operations should not be postponed. We aim to evaluate the profile and outcomes of COVID-19 patients who underwent emergency abdominal surgery. We performed a retrospective analysis of perioperative data of COVID-19 patients undergoing emergency surgery from April 2020 to August 2020. Eighty-two patients were evaluated due to abdominal complaints, yielding 22 emergency surgeries. The mean APACHE II and SAPS were 18.7 and 68, respectively. Six patients had a PaO /FiO lower than 200 and more than 50% of parenchymal compromise on chest tomography. The most common indications for emergency surgery were hernias (6; 27.2%). The median length of stay was 30 days, and only two patients required reoperation. Postoperatively, 10 (43.3%) patients needed mechanical ventilation for a mean of 6 days. The overall mortality rate was 31.8%. Both postoperative morbidity and mortality are high in COVID-19 patients with respiratory compromise and abdominal emergencies. |
| Author | dos Santos, Jones Pessoa dos Santos Miranda, Jocielle Pezzano, Alvaro Vicente Alvarez Rasslan, Roberto Damous, Sérgio Henrique Bastos Utiyama, Edivaldo Massazo Lunardeli, Henrique Simonsen Menegozzo, Carlos Augusto Metidieri |
| Author_xml | – sequence: 1 givenname: Roberto surname: Rasslan fullname: Rasslan, Roberto organization: Division of General Surgery and Trauma, Department of Surgery, University of Sao Paulo – sequence: 2 givenname: Jones Pessoa surname: dos Santos fullname: dos Santos, Jones Pessoa organization: Division of General Surgery and Trauma, Department of Surgery, University of Sao Paulo – sequence: 3 givenname: Carlos Augusto Metidieri orcidid: 0000-0003-3572-8977 surname: Menegozzo fullname: Menegozzo, Carlos Augusto Metidieri email: carlos.menegozzo@hc.fm.usp.br organization: Division of General Surgery and Trauma, Department of Surgery, University of Sao Paulo – sequence: 4 givenname: Alvaro Vicente Alvarez surname: Pezzano fullname: Pezzano, Alvaro Vicente Alvarez organization: Division of General Surgery and Trauma, Department of Surgery, University of Sao Paulo – sequence: 5 givenname: Henrique Simonsen surname: Lunardeli fullname: Lunardeli, Henrique Simonsen organization: Division of General Surgery and Trauma, Department of Surgery, University of Sao Paulo – sequence: 6 givenname: Jocielle surname: dos Santos Miranda fullname: dos Santos Miranda, Jocielle organization: Division of General Surgery and Trauma, Department of Surgery, University of Sao Paulo – sequence: 7 givenname: Edivaldo Massazo surname: Utiyama fullname: Utiyama, Edivaldo Massazo organization: Division of General Surgery and Trauma, Department of Surgery, University of Sao Paulo – sequence: 8 givenname: Sérgio Henrique Bastos surname: Damous fullname: Damous, Sérgio Henrique Bastos organization: Division of General Surgery and Trauma, Department of Surgery, University of Sao Paulo |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33625679$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1016/j.ijsu.2020.07.002 10.1007/s00423-020-01948-2 10.1308/rcsann.2020.0097 10.1590/0100-6991e-20202733 10.1016/j.jamcollsurg.2013.07.385 10.1002/bjs.10151 10.1111/all.14238 10.1056/NEJMoa2002032 10.1016/S0140-6736(07)61602-X 10.1097/SLA.0000000000003961 10.1371/journal.pone.0230548 10.1002/bjs.1800780327 10.1097/SLA.0000000000003925 10.1016/S0140-6736(20)31182-X 10.1097/01.sla.0000251364.32698.4b 10.1097/SLA.0000000000004030 10.1007/s00268-020-05575-2 10.1097/SLA.0000000000003963 10.1182/blood.2020006000 10.1080/110241502321116451 10.1097/01.sla.0000133083.54934.ae 10.1016/j.ijsu.2020.05.061 10.1016/j.surg.2020.04.035 10.1097/SLA.0000000000004004 |
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| Keywords | COVID-19 Abdominal surgery Acute abdomen SARS-CoV-2 Laparoscopy Emergency surgery |
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| License | This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
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COVID-19 is associated with high morbidity and mortality in patients undergoing surgery. Contrary to elective procedures, emergency operations should... COVID-19 is associated with high morbidity and mortality in patients undergoing surgery. Contrary to elective procedures, emergency operations should not be... PURPOSECOVID-19 is associated with high morbidity and mortality in patients undergoing surgery. Contrary to elective procedures, emergency operations should... |
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| SubjectTerms | Abdomen, Acute - mortality Abdomen, Acute - surgery Adolescent Adult Aged Aged, 80 and over APACHE Brazil - epidemiology COVID-19 - complications COVID-19 - mortality Emergencies Female Humans Length of Stay - statistics & numerical data Male Medicine Medicine & Public Health Middle Aged Original Original Article Pneumonia, Viral - complications Pneumonia, Viral - mortality Pneumonia, Viral - virology Respiration, Artificial Retrospective Studies SARS-CoV-2 Surgery |
| Title | Outcomes after emergency abdominal surgery in COVID-19 patients at a referral center in Brazil |
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