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Moulton A, Liu JK, Miguel de Virgilio C, Ozao-Choy J, Moazzez A. The Impact of Postoperative COVID-19 Infection on 30-day Outcomes of Laparoscopic Cholecystectomy. Am Surg 2024:31348241248800. [PMID: 38655851 DOI: 10.1177/00031348241248800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Introduction: Preoperative Coronavirus Disease 2019 (COVID-19) infections are associated with postoperative adverse outcomes. However, there is limited data on the impact of postoperative COVID-19 infection on postoperative outcomes of common general surgery procedures.Objective: To evaluate the impact of postoperative COVID-19 diagnosis on laparoscopic cholecystectomy outcomes.Methods: Patients with symptomatic cholelithiasis, acute cholecystitis, or gallstone pancreatitis who underwent laparoscopic cholecystectomy with or without intraoperative cholangiogram were identified using the 2021 National Surgical Quality Improvement Program (NSQIP) database. Patients were categorized into two groups: patients with and without a postoperative COVID-19 diagnosis. Coarsened Exact Matching was used to match the groups based on preoperative risk factors, and outcomes were compared.Results: A total of 47,948 patients were included. In the aggregate cohort, 31% were male, and mean age was 50 years. Age, BMI, smoking, COPD, CHF, preoperative sepsis, and ASA class were significantly different between the two groups. After matching, there were no differences in characteristics. 30-day morbidity (OR = 2.7, 95% CI 1.4-5.1), pneumonia (OR = 5.0, 95% CI 1.7-15.0), DVT (OR = 8.22, 95% CI 1.0-66), reoperation (OR = 9.3, 95% CI 1.2-73.8), and readmission (OR = 4.8, 95% CI 2.3-10.1) continued to be significantly worse in the matched cohort.Conclusion: Postoperative COVID-19 infection was associated with worse outcomes after laparoscopic cholecystectomy. These findings suggest that even postoperative COVID-19 diagnosis increases the risk for adverse outcomes in patients recovering from laparoscopic cholecystectomy and may indicate that precautions should be taken and new COVID-19 infections even after surgery should be closely monitored.
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Affiliation(s)
- Alexandra Moulton
- Department of Surgery, Harbor UCLA Medical Center, Torrance, CA, USA
| | - Jessica K Liu
- Department of Surgery, Harbor UCLA Medical Center, Torrance, CA, USA
- Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL, USA
| | - Christian Miguel de Virgilio
- Department of Surgery, Harbor UCLA Medical Center, Torrance, CA, USA
- Department of General Surgery, Harbor UCLA Medical Center, Torrance, CA, USA
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Junko Ozao-Choy
- Department of Surgery, Harbor UCLA Medical Center, Torrance, CA, USA
- Department of General Surgery, Harbor UCLA Medical Center, Torrance, CA, USA
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Ashkan Moazzez
- Department of Surgery, Harbor UCLA Medical Center, Torrance, CA, USA
- Department of General Surgery, Harbor UCLA Medical Center, Torrance, CA, USA
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA
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