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Unscreened: Urgent and Emergent Surgical Outcomes in the Early COVID-19 Pandemic

Background Creating useful recommendations for changes in surgical protocols during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been difficult due to a lack of studies based on representative samples. This study evaluates the clinical outcomes and characteristics of...

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Autores principales: Colosimo, Christina, Kelly, Jason, Coker, James, Bhuller, Sidra, Ballman, Eric, Baker-Sparr, Christina, Yon, James, Cornett, Brendon, Dziadkowiec, Oliwier, Weaver, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781775/
https://www.ncbi.nlm.nih.gov/pubmed/33415031
http://dx.doi.org/10.7759/cureus.11878
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author Colosimo, Christina
Kelly, Jason
Coker, James
Bhuller, Sidra
Ballman, Eric
Baker-Sparr, Christina
Yon, James
Cornett, Brendon
Dziadkowiec, Oliwier
Weaver, John
author_facet Colosimo, Christina
Kelly, Jason
Coker, James
Bhuller, Sidra
Ballman, Eric
Baker-Sparr, Christina
Yon, James
Cornett, Brendon
Dziadkowiec, Oliwier
Weaver, John
author_sort Colosimo, Christina
collection PubMed
description Background Creating useful recommendations for changes in surgical protocols during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been difficult due to a lack of studies based on representative samples. This study evaluates the clinical outcomes and characteristics of patients undergoing urgent or emergent surgeries. Methods This is a multi-center (eight-hospital), retrospective, observational study of urgent and emergent surgical patients from Colorado and Kansas, the United States, in the early stages of the SARS-CoV-2 pandemic. Patient groups were divided based on their coronavirus disease 2019 (COVID-19) status: positive, negative and untested. COVID-19 testing was performed after the surgery if patients were symptomatic. Results The analysis includes 5,547 patients who underwent surgery from March 1, 2020 to May 17, 2020. Seventy-four percent (4,096) were not tested for COVID-19 due to lack of symptoms. Out of the 1,451 tested patients, 1,412 tested negative, and 39 tested positive. Out of all the patients who tested positive, 69.23% were admitted to the intensive care unit (ICU), whereas 16.72% of untested and 21.25% of the negative patients. The invasive ventilation rate for the patients that tested positive was 46.15%, 4.22% for untested, and 8.85% for patients who tested negative. The mortality rate in the positive group was 7.69%, 1.10% in the untested group, and 1.56% in the positive group.    Conclusion Patients who tested positive for COVID-19 had worse clinical outcomes than patients who tested negative and untested. We recommend creating criteria for testing based on patient characteristics and surgical procedure rather than testing all patients awaiting surgery; this would allow us to conserve resources moving forward.
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spelling pubmed-77817752021-01-06 Unscreened: Urgent and Emergent Surgical Outcomes in the Early COVID-19 Pandemic Colosimo, Christina Kelly, Jason Coker, James Bhuller, Sidra Ballman, Eric Baker-Sparr, Christina Yon, James Cornett, Brendon Dziadkowiec, Oliwier Weaver, John Cureus General Surgery Background Creating useful recommendations for changes in surgical protocols during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been difficult due to a lack of studies based on representative samples. This study evaluates the clinical outcomes and characteristics of patients undergoing urgent or emergent surgeries. Methods This is a multi-center (eight-hospital), retrospective, observational study of urgent and emergent surgical patients from Colorado and Kansas, the United States, in the early stages of the SARS-CoV-2 pandemic. Patient groups were divided based on their coronavirus disease 2019 (COVID-19) status: positive, negative and untested. COVID-19 testing was performed after the surgery if patients were symptomatic. Results The analysis includes 5,547 patients who underwent surgery from March 1, 2020 to May 17, 2020. Seventy-four percent (4,096) were not tested for COVID-19 due to lack of symptoms. Out of the 1,451 tested patients, 1,412 tested negative, and 39 tested positive. Out of all the patients who tested positive, 69.23% were admitted to the intensive care unit (ICU), whereas 16.72% of untested and 21.25% of the negative patients. The invasive ventilation rate for the patients that tested positive was 46.15%, 4.22% for untested, and 8.85% for patients who tested negative. The mortality rate in the positive group was 7.69%, 1.10% in the untested group, and 1.56% in the positive group.    Conclusion Patients who tested positive for COVID-19 had worse clinical outcomes than patients who tested negative and untested. We recommend creating criteria for testing based on patient characteristics and surgical procedure rather than testing all patients awaiting surgery; this would allow us to conserve resources moving forward. Cureus 2020-12-03 /pmc/articles/PMC7781775/ /pubmed/33415031 http://dx.doi.org/10.7759/cureus.11878 Text en Copyright © 2020, Colosimo et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle General Surgery
Colosimo, Christina
Kelly, Jason
Coker, James
Bhuller, Sidra
Ballman, Eric
Baker-Sparr, Christina
Yon, James
Cornett, Brendon
Dziadkowiec, Oliwier
Weaver, John
Unscreened: Urgent and Emergent Surgical Outcomes in the Early COVID-19 Pandemic
title Unscreened: Urgent and Emergent Surgical Outcomes in the Early COVID-19 Pandemic
title_full Unscreened: Urgent and Emergent Surgical Outcomes in the Early COVID-19 Pandemic
title_fullStr Unscreened: Urgent and Emergent Surgical Outcomes in the Early COVID-19 Pandemic
title_full_unstemmed Unscreened: Urgent and Emergent Surgical Outcomes in the Early COVID-19 Pandemic
title_short Unscreened: Urgent and Emergent Surgical Outcomes in the Early COVID-19 Pandemic
title_sort unscreened: urgent and emergent surgical outcomes in the early covid-19 pandemic
topic General Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781775/
https://www.ncbi.nlm.nih.gov/pubmed/33415031
http://dx.doi.org/10.7759/cureus.11878
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