Risk of Early Postoperative Cardiovascular and Cerebrovascular Complication in Patients with Preoperative COVID-19 Undergoing Cancer Surgery. J Am Coll Surg 2024 Feb 13
Date
02/13/2024Pubmed ID
38348959DOI
10.1097/XCS.0000000000001039Abstract
BACKGROUND: As the COVID-19 pandemic shifts to an endemic phase, an increasing proportion of cancer patients with 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 (MACE) 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.
STUDY DESIGN: National COVID Cohort Collaborative (N3C) 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.
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 following infection. Postoperative MACE risk remained elevated 8+ weeks following infection in those with moderate disease. Vaccination did not reduce risk for postoperative MACE.
CONCLUSION: 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.
Author List
SenthilKumar G, Verhagen NB, Nimmer K, Yang X, Figueroa Castro CE, Szabo A, Taylor BW, Wainaina N, Gould JC, Kothari AN, N3C ConsortiumAuthors
Carlos E. Figueroa Castro MD Assistant Professor in the Medicine department at Medical College of WisconsinJon Gould MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Anai N. Kothari MD Assistant Professor in the Surgery department at Medical College of Wisconsin
Aniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
