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Risk of Early Postoperative Cardiovascular and Cerebrovascular Complication in Patients with Preoperative COVID-19 Undergoing Cancer Surgery.

Authors :
SenthilKumar G
Verhagen NB
Nimmer K
Yang X
Figueroa Castro CE
Szabo A
Taylor BW
Wainaina N
Gould JC
Kothari AN
Source :
Journal of the American College of Surgeons [J Am Coll Surg] 2024 Jun 01; Vol. 238 (6), pp. 1085-1097. Date of Electronic Publication: 2024 Feb 13.
Publication Year :
2024

Abstract

Background: As the COVID-19 pandemic shifts to an endemic phase, an increasing proportion of patients with cancer and a preoperative history of COVID-19 will require surgery. This study aimed to assess the influence of preoperative COVID-19 on postoperative risk for major adverse cardiovascular and cerebrovascular events (MACEs) among those undergoing surgical cancer resection. Secondary objectives included determining optimal time-to-surgery guidelines based on COVID-19 severity and discerning the influence of vaccination status on MACE risk.<br />Study Design: National COVID Cohort Collaborative Data Enclave, a large multi-institutional dataset, was used to identify patients that underwent surgical cancer resection between January 2020 and February 2023. Multivariate regression analysis adjusting for demographics, comorbidities, and risk of surgery was performed to evaluate risk for 30-day postoperative MACE.<br />Results: Of 204,371 included patients, 21,313 (10.4%) patients had a history of preoperative COVID-19. History of COVID-19 was associated with an increased risk for postoperative composite MACE as well as 30-day mortality. Among patients with mild disease who did not require hospitalization, MACE risk was elevated for up to 4 weeks after infection. Postoperative MACE risk remained elevated more than 8 weeks after infection in those with moderate disease. Vaccination did not reduce risk for postoperative MACE.<br />Conclusions: Together, these data highlight that assessment of the severity of preoperative COVID-19 infection should be a routine component of both preoperative patient screening as well as surgical risk stratification. In addition, strategies beyond vaccination that increase patients' cardiovascular fitness and prevent COVID-19 infection are needed.<br /> (Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Details

Language :
English
ISSN :
1879-1190
Volume :
238
Issue :
6
Database :
MEDLINE
Journal :
Journal of the American College of Surgeons
Publication Type :
Academic Journal
Accession number :
38348959
Full Text :
https://doi.org/10.1097/XCS.0000000000001039