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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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