Academic Journal
30-day postoperative mortality and the effects of hospital preparedness during the COVID-19 pandemic: a pooled analysis of prospective international cohort studies
| Τίτλος: | 30-day postoperative mortality and the effects of hospital preparedness during the COVID-19 pandemic: a pooled analysis of prospective international cohort studies |
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| Συγγραφείς: | Nepogodiev, Dmitri, Salvador, Renato, Zymperdikas, C, NIHR Global Health Research Unit on Global Surgery and COVIDSurg Collaborative, ZANUS, GIACOMO |
| Συνεισφορές: | Nepogodiev, Dmitri, Salvador, Renato, Zymperdikas, C, Nihr Global Health Research Unit On Global Surgery And Covidsurg, Collaborative |
| Στοιχεία εκδότη: | Elsevier Ltd. |
| Έτος έκδοσης: | 2026 |
| Συλλογή: | Padua Research Archive (IRIS - Università degli Studi di Padova) |
| Θεματικοί όροι: | COVID-19, Health system preparedne, Pandemic preparedne, Postoperative mortality, SARS-CoV-2, Surgery |
| Περιγραφή: | Background: Surgical services were poorly prepared for the COVID-19 pandemic, leading to widescale disruption to elective activity. This study aimed to identify actionable priorities to strengthen pandemic preparedness of surgical and hospital systems. Methods: This study pooled data from three international, prospective cohort studies including patients who had a positive SARS-CoV-2 test result in the seven days before or within 30 days after surgery. Patients were included across four pandemic time periods: Period 1 (January-May 2020), Period 2 (June-July 2020), Period 3 (October 2020), and Period 4 (December-March 2022). The primary outcome measure was 30-day postoperative mortality. Hierarchical logistic regression models were developed to explore association between pandemic periods (primary analysis) and hospital-level preparedness (secondary analysis) on 30-day postoperative mortality. Hospital preparedness was classified in to poorly-, moderately-, and highly-prepared tertiles based on Surgical Preparedness Index (SPI) score. Findings: A total of 31,751 patients were included from 1589 hospitals and 102 countries. From Period 1 through to Period 4 there was a decrease in the proportion of patients aged ≥70 years and with ASA grades 3-5.30-day postoperative mortality fell from Period 1 (18.4% [1378/7502]), Period 2 (9.9% [219/2234], adjusted odds ratio (aOR) 0.65, 95% confidence interval (CI) 0.53-0.78), Period 3 (10.5% [246/2427], aOR 0.60, 95% CI 0.50-0.71), through to Period 4 (5.8% [1132/19,588], aOR 0.33, 95% CI 0.30-0.37). During Period 4, SARS-CoV-2 vaccinated patients had lower mortality compared to unvaccinated patients (4.9% [603/12,361] versus 7.4% [529/7178], aOR 0.49, 95% CI 0.42-0.57). Compared to poorly-prepared hospitals (11.2% [1019/9071]), moderately-prepared (9.4% [857/9071], aOR 0.84, 95% CI 0.75-0.94) and highly-prepared hospitals (5.8% [530/9071], aOR 0.70, 95% CI 0.62-0.80) had lower mortality. Interpretation: Postoperative mortality decreased over the course of the COVID-19 ... |
| Τύπος εγγράφου: | article in journal/newspaper |
| Γλώσσα: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/41648988; info:eu-repo/semantics/altIdentifier/wos/WOS:001681088800001; volume:2026; issue:62; numberofpages:11; journal:THE LANCET REGIONAL HEALTH. EUROPE; https://hdl.handle.net/11577/3579979 |
| DOI: | 10.1016/j.lanepe.2025.101566 |
| Διαθεσιμότητα: | https://hdl.handle.net/11577/3579979 https://doi.org/10.1016/j.lanepe.2025.101566 |
| Rights: | info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/ |
| Αριθμός Καταχώρησης: | edsbas.A5BAAE7A |
| Βάση Δεδομένων: | BASE |
| DOI: | 10.1016/j.lanepe.2025.101566 |
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