A recent study suggests that patients recently diagnosed with COVID-19 might face elevated mortality risks following ambulatory surgery. Dr. George Williams from McGovern Medical School at The University of Texas Health Center at Houston highlighted the need for surgeries outside hospitals during the pandemic due to the strain on hospital resources. However, concerns emerged regarding patients’ recovery times and the urgency for surgeries, creating a gap in understanding.
Dr. Williams and his team conducted a retrospective review using the OPTUM de-identified COVID-19 electronic health record dataset. The study focused on assessing 30-day mortality among patients with recent COVID-19 infections who underwent surgery at ambulatory surgery centres. Analyzing 4,303 patients with recent COVID-19 diagnoses against 40,673 COVID-19 negative patients, the study revealed a higher risk of all-cause mortality in COVID-19 positive patients (odds ratio [OR], 2.51; P<0.001) compared to those without COVID-19.
Interestingly, mortality risks varied based on the timing of surgery post-COVID-19 diagnosis. Patients undergoing surgery within 15 and 31 to 45 days after diagnosis faced a higher risk compared to those who had surgery 46 to 180 days later.
The type of surgery also influenced outcomes, with patients undergoing colonoscopy or plastic and orthopaedic surgeries showing lower postoperative mortality risks compared to those undergoing other surgeries. Additionally, mortality increased with the severity of comorbidities, as indicated by the Charlson Comorbidity Index.
Dr. Girish Joshi from The University of Texas Southwestern Medical Center emphasized the need for optimal timing and patient condition for ambulatory surgeries, suggesting that surgeries should be postponed if patients have uncontrolled comorbidities or ongoing symptoms, including COVID-19 symptoms.
Dr. Williams emphasized the importance of delaying surgery for COVID-19-positive patients until symptoms subside, echoing recent recommendations from the American Society of Anesthesiologists (ASA) and the Anesthesia Patient Safety Foundation. He stressed that the findings support waiting up to seven weeks after a COVID-19 infection before undergoing surgery, even in ambulatory settings.
