Abstract
Concerning the perioperative outcomes of patients diagnosed with COVID-19 who underwent emergency laparotomy, more data must be collected. Because COVID-19 can affect multiple organs, cause various complications, and act as a risk factor for surgery, in this study, we aimed to compare the outcomes of emergency laparotomy between SARS-CoV-2 infected and uninfected patients. This retrospective cohort study was conducted on patients who underwent emergency laparotomy from December 2021 to December 2022. Postoperative outcomes were compared between patients with and without confirmed perioperative SARS-CoV-2 infection. The primary outcome was 30-day mortality. Secondary outcomes were postoperative intensive care unit admission, hospital length of stay, re-operation, and postoperative complications. Data were analyzed by SPSS statistic version 27. In this study, 50 patients in the COVID-19 group and 91 patients in the non-COVID-19 group were assessed. The 30-day mortality in the COVID-19 group was significantly higher than in the non-COVID-19 group (34% vs. 12.1%, respectively, P = 0.004). Postoperative complications were significantly higher in the COVID-19 group (64% vs. 26.4%, P < 0.001). The frequency of ICU admission and need for re-operation were significantly higher in the COVID-19 group (P = 0.003 and P = 0.039, respectively). Length of hospital stay was significantly lower in the non-COVID-19 group (P = 0.021). In patients with confirmed COVID-19, emergency laparotomy is associated with increased postoperative morbidity and mortality. Additionally, emergency laparotomy is associated with increasing postoperative complications, length of hospital stay, intensive care admission, and additional surgery requirement.
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The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
Announces COVID W (March 12, 2020) Outbreak a pandemic
Hu H, Ma F, Wei X, Fang Y (2021) Coronavirus fulminant myocarditis treated with glucocorticoid and human immunoglobulin. Eur Heart J 42(2):206
Zaim S, Chong JH, Sankaranarayanan V, Harky A (2020) COVID-19 and multiorgan response. Curr Probl Cardiol 45(8):100618
Cao X (2020) COVID-19: immunopathology and its implications for therapy. Nat Rev Immunol 20(5):269–270
Liu K, Fang Y-Y, Deng Y, Liu W, Wang M-F, Ma J-P et al (2020) Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J 133(09):1025–1031
Marietta M, Ageno W, Artoni A, De Candia E, Gresele P, Marchetti M et al (2020) COVID-19 and haemostasis: a position paper from Italian Society on Thrombosis and Haemostasis (SISET). Blood Transfus 18(3):167
Hogan BV, Peter MB, Shenoy HG, Horgan K, Hughes TA (2011) Surgery induced immunosuppression. Surgeon 9(1):38–43
Lei S, Jiang F, Su W, Chen C, Chen J, Mei W et al (2020) Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. eClin Med 21:100331
Bedwani NH, English W, Smith C, Singh S, Vulliamy P, Mukherjee S (2021) EP.WE.573 outcomes of emergency laparotomies during the COVID-19 pandemic—a retrospective cohort study. Br J Surg 108(11):1
Knisely A, Zhou ZN, Wu J, Huang Y, Holcomb K, Melamed A et al (2021) Perioperative morbidity and mortality of patients with COVID-19 who undergo urgent and emergent surgical procedures. Ann Surg 273(1):34–40
Montauban P, Balakumar C, Rait J, Zarsadias P, Shahzad F, Ogbuagu N et al (2023) Impact of the COVID-19 pandemic on the management and outcomes of emergency surgical patients: a retrospective cohort study. J Perioper Pract 33(1–2):37–47
Abate SM, Mantefardo B, Basu B (2020) Postoperative mortality among surgical patients with COVID-19: a systematic review and meta-analysis. Patient Saf Surg 14:37
Collaborative C, Morton D (2020) Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet 396(10243):27–38
COVIDSurg Collaborative (2022) Mortality and pulmonary complications in emergency general surgery patients with COVID-19: a large international multicenter study. J Trauma Acute Care Surg 93(1):59–65
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213
von Elm E et al (2007) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet (London) 370(9596):1453–1457
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Dr. AMT, participated in supervision and validation. Dr. AH, participated in writing—review and editing and data curation. Dr. AHT, participated in methodology, and writing—original draft and analysis. Dr. HK participated in term, analysis, and visualization. Dr. MA: conceptualization, project administration, and corresponding author.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. That meets to ethical committee of Shahid Beheshti University of Medical Sciences and accepted with Registration code: (IR.SBMU.MSP.REC.1400.548).
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Mohammadi Tofigh, A., Hasanzade, A., Haghbin Toutounchi, A. et al. Emergency laparotomy and perioperative COVID-19: a single-center retrospective cohort study. Updates Surg 76, 699–703 (2024). https://doi.org/10.1007/s13304-023-01730-1
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DOI: https://doi.org/10.1007/s13304-023-01730-1