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Perioperative Factors Impact on Mortality and Survival Rate of Geriatric Patients Undergoing Surgery in the COVID-19 Pandemic: A Prospective Cohort Study in Indonesia
Background: The COVID-19 pandemic continues to have an impact on geriatric patients worldwide since geriatrics itself is an age group with a high risk due to declined physiological function and many comorbidities, especially for those who undergo surgery. In this study, we determine the association...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9506116/ https://www.ncbi.nlm.nih.gov/pubmed/36142942 http://dx.doi.org/10.3390/jcm11185292 |
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author | Rehatta, Nancy Margarita Chandra, Susilo Sari, Djayanti Lestari, Mayang Indah Senapathi, Tjokorda Gde Agung Nurdin, Haizah Wirabuana, Belindo Pramodana, Bintang Pradhana, Adinda Putra Isngadi, Isngadi Anggraeni, Novita Sikumbang, Kenanga Marwan Halimi, Radian Ahmad Jasa, Zafrullah Khany Nasution, Akhyar Hamonangan Mochamat, Mochamat Purwoko, Purwoko |
author_facet | Rehatta, Nancy Margarita Chandra, Susilo Sari, Djayanti Lestari, Mayang Indah Senapathi, Tjokorda Gde Agung Nurdin, Haizah Wirabuana, Belindo Pramodana, Bintang Pradhana, Adinda Putra Isngadi, Isngadi Anggraeni, Novita Sikumbang, Kenanga Marwan Halimi, Radian Ahmad Jasa, Zafrullah Khany Nasution, Akhyar Hamonangan Mochamat, Mochamat Purwoko, Purwoko |
author_sort | Rehatta, Nancy Margarita |
collection | PubMed |
description | Background: The COVID-19 pandemic continues to have an impact on geriatric patients worldwide since geriatrics itself is an age group with a high risk due to declined physiological function and many comorbidities, especially for those who undergo surgery. In this study, we determine the association between perioperative factors with 30-day mortality and a survival rate of geriatric patients undergoing surgery during COVID-19 pandemic. Methods: A prospective cohort study was conducted at 14 central hospitals in Indonesia. The recorded variables were perioperative factors, 30-day mortality, and survival rate. Analyses of associations between variables and 30-day mortality were performed using univariate/multivariable logistic regression, and survival rates were determined with Kaplan–Meier survival analysis. Results: We analyzed 1621 elderly patients. The total number of patients who survived within 30 days of observation was 4.3%. Several perioperative factors were associated with 30-day mortality (p < 0.05) is COVID-19 (OR, 4.34; 95% CI, 1.04–18.07; p = 0.04), CCI > 3 ( odds ratio [OR], 2.33; 95% confidence interval [CI], 1.03–5.26; p = 0.04), emergency surgery (OR, 3.70; 95% CI, 1.96–7.00; p ≤ 0.01), postoperative ICU care (OR, 2.70; 95% CI, 1.32–5.53; p = 0.01), and adverse events (AEs) in the ICU (OR, 3.43; 95% CI, 1.32–8.96; p = 0.01). Aligned with these findings, COVID-19, CCI > 3, and comorbidities have a log-rank p < 0.05. The six comorbidities that have log-rank p < 0.05 are moderate-to-severe renal disease (log-rank p ≤ 0.01), cerebrovascular disease (log-rank p ≤ 0.01), diabetes with chronic complications (log-rank p = 0.03), metastatic solid tumor (log-rank p = 0.02), dementia (log-rank p ≤ 0.01), and rheumatology disease (log-rank p = 0.03). Conclusions: Having at least one of these conditions, such as COVID-19, comorbidities, emergency surgery, postoperative ICU care, or an AE in the ICU were associated with increased mortality in geriatric patients undergoing surgery during the COVID-19 pandemic. |
format | Online Article Text |
id | pubmed-9506116 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-95061162022-09-24 Perioperative Factors Impact on Mortality and Survival Rate of Geriatric Patients Undergoing Surgery in the COVID-19 Pandemic: A Prospective Cohort Study in Indonesia Rehatta, Nancy Margarita Chandra, Susilo Sari, Djayanti Lestari, Mayang Indah Senapathi, Tjokorda Gde Agung Nurdin, Haizah Wirabuana, Belindo Pramodana, Bintang Pradhana, Adinda Putra Isngadi, Isngadi Anggraeni, Novita Sikumbang, Kenanga Marwan Halimi, Radian Ahmad Jasa, Zafrullah Khany Nasution, Akhyar Hamonangan Mochamat, Mochamat Purwoko, Purwoko J Clin Med Article Background: The COVID-19 pandemic continues to have an impact on geriatric patients worldwide since geriatrics itself is an age group with a high risk due to declined physiological function and many comorbidities, especially for those who undergo surgery. In this study, we determine the association between perioperative factors with 30-day mortality and a survival rate of geriatric patients undergoing surgery during COVID-19 pandemic. Methods: A prospective cohort study was conducted at 14 central hospitals in Indonesia. The recorded variables were perioperative factors, 30-day mortality, and survival rate. Analyses of associations between variables and 30-day mortality were performed using univariate/multivariable logistic regression, and survival rates were determined with Kaplan–Meier survival analysis. Results: We analyzed 1621 elderly patients. The total number of patients who survived within 30 days of observation was 4.3%. Several perioperative factors were associated with 30-day mortality (p < 0.05) is COVID-19 (OR, 4.34; 95% CI, 1.04–18.07; p = 0.04), CCI > 3 ( odds ratio [OR], 2.33; 95% confidence interval [CI], 1.03–5.26; p = 0.04), emergency surgery (OR, 3.70; 95% CI, 1.96–7.00; p ≤ 0.01), postoperative ICU care (OR, 2.70; 95% CI, 1.32–5.53; p = 0.01), and adverse events (AEs) in the ICU (OR, 3.43; 95% CI, 1.32–8.96; p = 0.01). Aligned with these findings, COVID-19, CCI > 3, and comorbidities have a log-rank p < 0.05. The six comorbidities that have log-rank p < 0.05 are moderate-to-severe renal disease (log-rank p ≤ 0.01), cerebrovascular disease (log-rank p ≤ 0.01), diabetes with chronic complications (log-rank p = 0.03), metastatic solid tumor (log-rank p = 0.02), dementia (log-rank p ≤ 0.01), and rheumatology disease (log-rank p = 0.03). Conclusions: Having at least one of these conditions, such as COVID-19, comorbidities, emergency surgery, postoperative ICU care, or an AE in the ICU were associated with increased mortality in geriatric patients undergoing surgery during the COVID-19 pandemic. MDPI 2022-09-08 /pmc/articles/PMC9506116/ /pubmed/36142942 http://dx.doi.org/10.3390/jcm11185292 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Rehatta, Nancy Margarita Chandra, Susilo Sari, Djayanti Lestari, Mayang Indah Senapathi, Tjokorda Gde Agung Nurdin, Haizah Wirabuana, Belindo Pramodana, Bintang Pradhana, Adinda Putra Isngadi, Isngadi Anggraeni, Novita Sikumbang, Kenanga Marwan Halimi, Radian Ahmad Jasa, Zafrullah Khany Nasution, Akhyar Hamonangan Mochamat, Mochamat Purwoko, Purwoko Perioperative Factors Impact on Mortality and Survival Rate of Geriatric Patients Undergoing Surgery in the COVID-19 Pandemic: A Prospective Cohort Study in Indonesia |
title | Perioperative Factors Impact on Mortality and Survival Rate of Geriatric Patients Undergoing Surgery in the COVID-19 Pandemic: A Prospective Cohort Study in Indonesia |
title_full | Perioperative Factors Impact on Mortality and Survival Rate of Geriatric Patients Undergoing Surgery in the COVID-19 Pandemic: A Prospective Cohort Study in Indonesia |
title_fullStr | Perioperative Factors Impact on Mortality and Survival Rate of Geriatric Patients Undergoing Surgery in the COVID-19 Pandemic: A Prospective Cohort Study in Indonesia |
title_full_unstemmed | Perioperative Factors Impact on Mortality and Survival Rate of Geriatric Patients Undergoing Surgery in the COVID-19 Pandemic: A Prospective Cohort Study in Indonesia |
title_short | Perioperative Factors Impact on Mortality and Survival Rate of Geriatric Patients Undergoing Surgery in the COVID-19 Pandemic: A Prospective Cohort Study in Indonesia |
title_sort | perioperative factors impact on mortality and survival rate of geriatric patients undergoing surgery in the covid-19 pandemic: a prospective cohort study in indonesia |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9506116/ https://www.ncbi.nlm.nih.gov/pubmed/36142942 http://dx.doi.org/10.3390/jcm11185292 |
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