Adverse postoperative outcomes not increased with recent COVID-19

Recent COVID-19 infection seems not to be associated with the risk for adverse postoperative outcomes, according to a research letter published online March 28 in JAMA Network Open.

William J. O'Brien, from the Center for Healthcare Organization and Implementation Research at Veterans Affairs Boston, and colleagues examined the risk for adverse postoperative outcomes among patients with recent infection, emulating a trial conducted in a large veteran population. A total of 29,093 patients (mean age, 66.1 years) underwent surgery at 123 hospitals from Jan. 1 to Sept. 30, 2021.

The researchers noted there was a median of 30 days between infection and surgery. Overall, 4.7 percent of the 28,635 patients without COVID-19 had adverse postoperative outcomes compared with 7.6 and 3.2 percent within the group with a one- to 30-day infection and the group with a 31- to 60-day infection, respectively.

Among those with infection during preoperative days 1 to 30 and 31 to 60, the odds ratios for any adverse postoperative outcomes, including 30-day mortality, cardiac outcomes, central nervous system outcomes, respiratory outcomes, infection disease outcomes, or thromboembolic outcomes, were 1.40 (95 percent confidence interval, 0.77 to 2.35) and 0.68 (95 percent confidence interval, 0.26 to 1.42), respectively.

"Current evidence suggests the decision to proceed should be based on clinical expertise rather than a fixed time interval after infection, consistent with current guidelines," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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