{"id":1744,"date":"2022-12-16T00:00:00","date_gmt":"2022-12-16T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/complications-following-elective-major-noncardiac-surgery-among-patients-with-prior-sars-cov-2-infection\/"},"modified":"2023-07-19T10:20:22","modified_gmt":"2023-07-19T14:20:22","slug":"complications-following-elective-major-noncardiac-surgery-among-patients-with-prior-sars-cov-2-infection","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/complications-following-elective-major-noncardiac-surgery-among-patients-with-prior-sars-cov-2-infection\/","title":{"rendered":"Complications following elective major noncardiac surgery among patients with prior SARS-CoV-2 infection"},"content":{"rendered":"

Importance<\/strong> \u2014 There is an urgent need for evidence to inform preoperative risk assessment for the millions of people who have had SARS-CoV-2 infection and are awaiting elective surgery, which is critical to surgical care planning and informed consent.<\/p>\n

Objective<\/strong> \u2014 To assess the association of prior SARS-CoV-2 infection with death, major adverse cardiovascular events, and rehospitalization after elective major noncardiac surgery.<\/p>\n

Design, Setting, and Participan<\/strong>ts \u2014 This population-based cohort study included adults who had received a polymerase chain reaction test for SARS-CoV-2 infection within 6 months prior to elective major noncardiac surgery in Ontario, Canada, between April 2020 and October 2021, with 30 days follow-up.<\/p>\n

Exposures<\/strong> \u2014 Positive SARS-CoV-2 polymerase chain reaction test result.<\/p>\n

Main Outcomes and Measures<\/strong> \u2014 The main outcome was the composite of death, major adverse cardiovascular events, and all-cause rehospitalization within 30 days after surgery.<\/p>\n

Results<\/strong> \u2014 Of 71 144 patients who underwent elective major noncardiac surgery (median age, 66 years [IQR, 57-73 years]; 59.8% female), 960 had prior SARS-CoV-2 infection (1.3%) and 70 184 had negative test results (98.7%). Prior infection was not associated with the composite risk of death, major adverse cardiovascular events, and rehospitalization within 30 days of elective major noncardiac surgery (5.3% absolute event rate [n = 3770]; 960 patients with a positive test result; adjusted relative risk [aRR], 0.91; 95% CI, 0.68-1.21). There was also no association between prior infection with SARS-CoV-2 and postoperative outcomes when the time between infection and surgery was less than 4 weeks (aRR, 1.15; 95% CI, 0.64-2.09) or less than 7 weeks (aRR, 0.95; 95% CI, 0.56-1.61) and among those who were previously vaccinated (aRR, 0.81; 95% CI, 0.52-1.26).<\/p>\n

Conclusions and Relevance<\/strong> \u2014 In this study, prior infection with SARS-CoV-2 was not associated with death, major adverse cardiovascular events, or rehospitalization following elective major noncardiac surgery, although low event rates and wide 95% CIs do not preclude a potentially meaningful increase in overall risk.<\/p>\n","protected":false},"excerpt":{"rendered":"

Importance \u2014 There is an urgent need for evidence to inform preoperative risk assessment for the millions of people who have had SARS-CoV-2 infection and are awaiting elective surgery, which is critical to surgical care planning and informed consent. Objective \u2014 To assess the association of prior SARS-CoV-2 infection with death, major adverse cardiovascular events, […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[39,25],"migration-helper-qa-sample-set":[],"class_list":["post-1744","journal_article","type-journal_article","status-publish","hentry","topic-infectious-diseases","topic-surgery"],"acf":{"citation":"Quinn KL, Huang A, Bell CM, Detsky AS, Lapointe-Shaw L, Rosella LC, Urbach DR, Razak F, Verma AA. JAMA Netw Open<\/em>. 2022; 5(12):e2247341. Epub 2022 Dec 16.","source_url":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2799632","ices_scientist":[1104,1172,1287,1339,1343,17132,21862],"site":[6733],"research_program":[6747],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"C2C6F818-3011-4A2A-B8C9-61F34B465E63","sitecore_item_name":"Complications-following-elective-major-noncardiac-surgery-among-patients-with-prior-SARS-CoV-2","sitecore_field_values":"{\r\n \"Title\": \"Complications following elective major noncardiac surgery among patients with prior SARS-CoV-2 infection\",\r\n \"Short title\": \"Complications following elective major\",\r\n \"Summary\": \"The study objective was to assess the association of prior SARS-CoV-2 infection with death, major adverse cardiovascular events, and rehospitalization after elective major noncardiac surgery.\",\r\n \"Citation\": \"

Quinn KL, Huang A, Bell CM, Detsky AS, Lapointe-Shaw L, Rosella LC, Urbach DR, Razak F, Verma AA. JAMA Netw Open<\/em>. 2022; 5(12):e2247341. Epub 2022 Dec 16. DOI: https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.47341<\/a><\/p>\",\r\n \"Abstract\": \"

Importance<\/strong> — There is an urgent need for evidence to inform preoperative risk assessment for the millions of people who have had SARS-CoV-2 infection and are awaiting elective surgery, which is critical to surgical care planning and informed consent.<\/p>n

Objective<\/strong> — To assess the association of prior SARS-CoV-2 infection with death, major adverse cardiovascular events, and rehospitalization after elective major noncardiac surgery.<\/p>n

Design, Setting, and Participants<\/span> — This population-based cohort study included adults who had received a polymerase chain reaction test for SARS-CoV-2 infection within 6 months prior to elective major noncardiac surgery in Ontario, Canada, between April 2020 and October 2021, with 30 days follow-up.<\/p>n

Exposures<\/strong> — Positive SARS-CoV-2 polymerase chain reaction test result.<\/p>n

Main Outcomes and Measures<\/span> — The main outcome was the composite of death, major adverse cardiovascular events, and all-cause rehospitalization within 30 days after surgery.<\/p>n

Results<\/strong> — Of 71 144 patients who underwent elective major noncardiac surgery (median age, 66 years [IQR, 57-73 years]; 59.8% female), 960 had prior SARS-CoV-2 infection (1.3%) and 70 184 had negative test results (98.7%). Prior infection was not associated with the composite risk of death, major adverse cardiovascular events, and rehospitalization within 30 days of elective major noncardiac surgery (5.3% absolute event rate [n = 3770]; 960 patients with a positive test result; adjusted relative risk [aRR], 0.91; 95% CI, 0.68-1.21). There was also no association between prior infection with SARS-CoV-2 and postoperative outcomes when the time between infection and surgery was less than 4 weeks (aRR, 1.15; 95% CI, 0.64-2.09) or less than 7 weeks (aRR, 0.95; 95% CI, 0.56-1.61) and among those who were previously vaccinated (aRR, 0.81; 95% CI, 0.52-1.26).<\/p>n

Conclusions and Relevance<\/span> — In this study, prior infection with SARS-CoV-2 was not associated with death, major adverse cardiovascular events, or rehospitalization following elective major noncardiac surgery, although low event rates and wide 95% CIs do not preclude a potentially meaningful increase in overall risk.<\/p>n

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