Factors Associated With Surgical Mortality and Complications Among Patients With and Without Coronavirus Disease 2019 (COVID-19) in Italy
Francesco Doglietto, MD, PhD1; Marika Vezzoli, PhD2; Federico Gheza, MD3; et al Gian Luca Lussardi, MD4; Marco Domenicucci, MD5; Luca Vecchiarelli, MD6; Luca Zanin, MD1; Giorgio Saraceno, MD1; Liana Signorini, MD7; Pier Paolo Panciani, MD, PhD1; Francesco Castelli, MD7; Roberto Maroldi, MD8; Francesco Antonio Rasulo, MD9; Mauro Roberto Benvenuti, MD6; Nazario Portolani, MD3; Stefano Bonardelli, MD4; Giuseppe Milano, MD10; Alessandro Casiraghi, MD5; Stefano Calza, PhD2; Marco Maria Fontanella, MD1
Author Affiliations Article Information
JAMA Surg. Published online June 12, 2020. doi:10.1001/jamasurg.2020.2713
Abstract
Importance There are limited data on mortality and complications rates in patients with coronavirus disease 2019 (COVID-19) who undergo surgery.
Objective To evaluate early surgical outcomes of patients with COVID-19 in different subspecialties.
Design, Setting, and Participants This matched cohort study conducted in the general, vascular and thoracic surgery, orthopedic, and neurosurgery units of Spedali Civili Hospital (Brescia, Italy) included patients who underwent surgical treatment from February 23 to April 1, 2020, and had positive test results for COVID-19 either before or within 1 week after surgery. Gynecological and minor surgical procedures were excluded. Patients with COVID-19 were matched with patients without COVID-19 with a 1:2 ratio for sex, age group, American Society of Anesthesiologists score, and comorbidities recorded in the surgical risk calculator of the American College of Surgeons National Surgical Quality Improvement Program. Patients older than 65 years were also matched for the Clinical Frailty Scale score.
