COVID-19 patients have greatly increased risk of postop mortality

Editor's Note

Patients having surgery after contracting COVID-19 are at greatly increased risk of postoperative death, this study finds.

Researchers examined data for 1,128 patients from 235 hospitals in 24 countries. Overall 30-day postoperative mortality was 23.8%.

Mortality was high across all subgroups including:

• elective surgery, 18.9%
• emergency surgery, 25.6%
• minor surgery like appendectomy or hernia repair, 16.3%
• major surgery like for hip replacement or colon cancer, 26.9%.

Mortality rates also were higher in men (28.4%) vs women (18.2%) and in patients aged 70 years or more (33.7%) vs patients less than 70 years (13.9%).

In the 30 days following surgery, 51.2% of patients developed pneumonia, acute respiratory distress syndrome, or required ventilation. Most of the patients who died (81.7%) had experienced pulmonary complications.

The researchers recommend that thresholds for surgery during the COVID-19 pandemic be raised, compared to normal practice.