摘要
Background:Currently,the effect of the 2022 nationwide coronavirus disease 2019(COVID-19)wave on the perioperative prognosis of surgical patients in China is unclear.Thus,we aimed to explore its influence on postoperative morbidity and mortality in surgical patients.Methods:An ambispective cohort study was conducted at Xijing Hospital,China.We collected 10-day time-series data from December 29 until January 7 for the 2018-2022 period.The primary outcome was major postoperative complications(Clavien-Dindo class III-V).The association between COVID-19 exposure and postoperative prognosis was explored by comparing consecutive 5-year data at the population level and by comparing patients with and without COVID-19 exposure at the patient level.Results:The entire cohort consisted of 3350 patients(age:48.5±19.2 years),including 1759 females(52.5%).Overall,961(28.7%)underwent emergency surgery,and 553(16.5%)had COVID-19 exposure(from the 2022 cohort).At the population level,major postoperative complications occurred in 5.9%(42/707),5.7%(53/935),5.1%(46/901),9.4%(11/117),and 22.0%(152/690)patients in the 2018-2022 cohorts,respectively.After adjusting for potential confounding factors,the 2022 cohort(80%patients with COVID-19 history)had a significantly higher postoperative major complication risk than did the 2018 cohort(adjusted risk difference[aRD],14.9%(95%confidence interval[CI],11.5-18.4%);adjusted odds ratio[aOR],8.19(95%CI,5.24-12.81)).At the patient level,the incidence of major postoperative complications was significantly greater in patients with(24.6%,136/553)than that in patients without COVID-19 history(6.0%[168/2797];aRD,17.8%[95%CI,13.6-22.1%];aOR,7.89[95%CI,5.76-10.83]).Secondary outcomes of postoperative pulmonary complications were consistent with primary findings.These findings were verified through sensitivity analyses using time-series data projections and propensity score matching.Conclusion:Based on a single-center observation,patients with recent COVID-19 exposure were likely to have a high incidence of major postoperative complications.Registration:NCT05677815 at https://clinicaltrials.gov/.
