查看文章

Perioperative SARSCoV2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARSCoV2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with preoperative SARSCoV2 infection were compared with those without previous SARSCoV2 infection. The primary outcome measure was 30day postoperative mortality. Logistic regression models were used to calculate adjusted 30day mortality rates stratified by time from diagnosis of SARSCoV2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a preoperative SARSCoV2 diagnosis. Adjusted 30day mortality in patients without SARSCoV2 infection was 1.5% (95%CI 1.4–1.5). In patients with a preoperative SARSCoV2 diagnosis, mortality was increased in patients having surgery within 0–2 weeks, 3–4 weeks and 5–6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3–4.8), 3.9 (2.6–5.1) and 3.6 (2.0–5.2), respectively). Surgery performed ≥ 7 weeks after SARSCoV2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9–2.1)). After a ≥ 7 week delay in undertaking surgery following SARSCoV2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2–8.7) vs. 2.4% (95%CI 1.4–3.4) vs. 1.3% (95%CI 0.6–2.0), respectively). Where possible, surgery should be delayed for at …