Cargando…

Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection

BACKGROUND: An increasing number of patients with cancer diagnoses and prior SARS-CoV-2 infection will require surgical treatment. The objective of this study was to determine whether a history of SARS-CoV-2 infection increases the risk of adverse postoperative events following surgery in patients w...

Descripción completa

Detalles Bibliográficos
Autores principales: Kothari, Anai N., DiBrito, Sandra R., Lee, J. Jack, Caudle, Abigail S., Clemens, Mark W., Gottumukkala, Vijaya N., Katz, Matthew H. G., Offodile, Anaeze C., Uppal, Abhineet, Chang, George J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235912/
https://www.ncbi.nlm.nih.gov/pubmed/34176060
http://dx.doi.org/10.1245/s10434-021-10291-9
_version_ 1783714427865923584
author Kothari, Anai N.
DiBrito, Sandra R.
Lee, J. Jack
Caudle, Abigail S.
Clemens, Mark W.
Gottumukkala, Vijaya N.
Katz, Matthew H. G.
Offodile, Anaeze C.
Uppal, Abhineet
Chang, George J.
author_facet Kothari, Anai N.
DiBrito, Sandra R.
Lee, J. Jack
Caudle, Abigail S.
Clemens, Mark W.
Gottumukkala, Vijaya N.
Katz, Matthew H. G.
Offodile, Anaeze C.
Uppal, Abhineet
Chang, George J.
author_sort Kothari, Anai N.
collection PubMed
description BACKGROUND: An increasing number of patients with cancer diagnoses and prior SARS-CoV-2 infection will require surgical treatment. The objective of this study was to determine whether a history of SARS-CoV-2 infection increases the risk of adverse postoperative events following surgery in patients with cancer. METHODS: This was a propensity-matched cohort study from April 6, 2020 to October 31, 2020 at the UT MD Anderson Cancer Center. Cancer patients were identified who underwent elective surgery after recovering from SARS-CoV-2 infection and matched to controls based on patient, disease, and surgical factors. Primary study outcome was a composite of the following adverse postoperative events that occurred within 30 days of surgery: death, unplanned readmission, pneumonia, cardiac injury, or thromboembolic event. RESULTS: A total of 5682 patients were included for study, and 114 (2.0%) had a prior SARS-CoV-2 infection. The average time from infection to surgery was 52 (range 20–202) days. Compared with matched controls, there was no difference in the rate of adverse postoperative outcome (14.3% vs. 13.4%, p = 1.0). Patients with a SARS-CoV-2-related inpatient admission before surgery had increased odds of postoperative complication (adjusted odds ratio [aOR] 7.4 [1.6–34.3], p = 0.01). CONCLUSIONS: A minimal wait time of 20 days after recovering from minimally symptomatic SARS-CoV-2 infection appears to be safe for cancer patients undergoing low-risk elective surgery. Patients with SARS-CoV-2 infections requiring inpatient treatment were at increased risk for adverse events after surgery. Additional wait time may be required in those with more severe infections. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1245/s10434-021-10291-9.
format Online
Article
Text
id pubmed-8235912
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Springer International Publishing
record_format MEDLINE/PubMed
spelling pubmed-82359122021-06-28 Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection Kothari, Anai N. DiBrito, Sandra R. Lee, J. Jack Caudle, Abigail S. Clemens, Mark W. Gottumukkala, Vijaya N. Katz, Matthew H. G. Offodile, Anaeze C. Uppal, Abhineet Chang, George J. Ann Surg Oncol Global Health Services Research BACKGROUND: An increasing number of patients with cancer diagnoses and prior SARS-CoV-2 infection will require surgical treatment. The objective of this study was to determine whether a history of SARS-CoV-2 infection increases the risk of adverse postoperative events following surgery in patients with cancer. METHODS: This was a propensity-matched cohort study from April 6, 2020 to October 31, 2020 at the UT MD Anderson Cancer Center. Cancer patients were identified who underwent elective surgery after recovering from SARS-CoV-2 infection and matched to controls based on patient, disease, and surgical factors. Primary study outcome was a composite of the following adverse postoperative events that occurred within 30 days of surgery: death, unplanned readmission, pneumonia, cardiac injury, or thromboembolic event. RESULTS: A total of 5682 patients were included for study, and 114 (2.0%) had a prior SARS-CoV-2 infection. The average time from infection to surgery was 52 (range 20–202) days. Compared with matched controls, there was no difference in the rate of adverse postoperative outcome (14.3% vs. 13.4%, p = 1.0). Patients with a SARS-CoV-2-related inpatient admission before surgery had increased odds of postoperative complication (adjusted odds ratio [aOR] 7.4 [1.6–34.3], p = 0.01). CONCLUSIONS: A minimal wait time of 20 days after recovering from minimally symptomatic SARS-CoV-2 infection appears to be safe for cancer patients undergoing low-risk elective surgery. Patients with SARS-CoV-2 infections requiring inpatient treatment were at increased risk for adverse events after surgery. Additional wait time may be required in those with more severe infections. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1245/s10434-021-10291-9. Springer International Publishing 2021-06-26 2021 /pmc/articles/PMC8235912/ /pubmed/34176060 http://dx.doi.org/10.1245/s10434-021-10291-9 Text en © Society of Surgical Oncology 2021 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.
spellingShingle Global Health Services Research
Kothari, Anai N.
DiBrito, Sandra R.
Lee, J. Jack
Caudle, Abigail S.
Clemens, Mark W.
Gottumukkala, Vijaya N.
Katz, Matthew H. G.
Offodile, Anaeze C.
Uppal, Abhineet
Chang, George J.
Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection
title Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection
title_full Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection
title_fullStr Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection
title_full_unstemmed Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection
title_short Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection
title_sort surgical outcomes in cancer patients undergoing elective surgery after recovering from mild-to-moderate sars-cov-2 infection
topic Global Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235912/
https://www.ncbi.nlm.nih.gov/pubmed/34176060
http://dx.doi.org/10.1245/s10434-021-10291-9
work_keys_str_mv AT kotharianain surgicaloutcomesincancerpatientsundergoingelectivesurgeryafterrecoveringfrommildtomoderatesarscov2infection
AT dibritosandrar surgicaloutcomesincancerpatientsundergoingelectivesurgeryafterrecoveringfrommildtomoderatesarscov2infection
AT leejjack surgicaloutcomesincancerpatientsundergoingelectivesurgeryafterrecoveringfrommildtomoderatesarscov2infection
AT caudleabigails surgicaloutcomesincancerpatientsundergoingelectivesurgeryafterrecoveringfrommildtomoderatesarscov2infection
AT clemensmarkw surgicaloutcomesincancerpatientsundergoingelectivesurgeryafterrecoveringfrommildtomoderatesarscov2infection
AT gottumukkalavijayan surgicaloutcomesincancerpatientsundergoingelectivesurgeryafterrecoveringfrommildtomoderatesarscov2infection
AT katzmatthewhg surgicaloutcomesincancerpatientsundergoingelectivesurgeryafterrecoveringfrommildtomoderatesarscov2infection
AT offodileanaezec surgicaloutcomesincancerpatientsundergoingelectivesurgeryafterrecoveringfrommildtomoderatesarscov2infection
AT uppalabhineet surgicaloutcomesincancerpatientsundergoingelectivesurgeryafterrecoveringfrommildtomoderatesarscov2infection
AT surgicaloutcomesincancerpatientsundergoingelectivesurgeryafterrecoveringfrommildtomoderatesarscov2infection
AT changgeorgej surgicaloutcomesincancerpatientsundergoingelectivesurgeryafterrecoveringfrommildtomoderatesarscov2infection