Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study

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dc.contributor.authorSimoes, J.F.,
dc.contributor.authorLi, E
dc.contributor.authorNepogodiev, D.,
dc.contributor.authorBhangu, A.,
dc.contributor.authorAbdur-Rahman, LO., ...............
dc.contributor.author.......... Gwadabe Sadiya Musa........... et al
dc.date.accessioned2026-08-27T12:13:36Z
dc.date.available2026-08-27T12:13:36Z
dc.date.issued2021-07-14
dc.description.abstractWeaimedtodeterminetheimpactofpre-operativeisolationonpostoperativepulmonarycomplicationsafter electivesurgeryduringtheglobalSARS-CoV-2pandemic.Weperformedaninternationalprospectivecohort study includingpatientsundergoingelectivesurgery inOctober2020. Isolationwasdefinedastheperiod beforesurgeryduringwhichpatientsdidnotleavetheirhouseorreceivevisitorsfromoutsidetheirhousehold. Theprimaryoutcomewaspostoperativepulmonary complications, adjusted inmultivariablemodels for measuredconfounders.Pre-definedsub-groupanalyseswereperformedfortheprimaryoutcome.Atotalof 96,454patientsfrom114countrieswereincludedandoverall,26,948(27.9%)patientsisolatedbeforesurgery. Postoperativepulmonarycomplicationswererecordedin1947(2.0%)patientsofwhich227(11.7%)were associatedwithSARS-CoV-2infection.Patientswhoisolatedpre-operativelywereolder,hadmorerespiratory comorbiditiesandweremorecommonlyfromareasofhighSARS-CoV-2incidenceandhigh-incomecountries. Althoughtheoverall ratesofpostoperativepulmonarycomplicationsweresimilar inthosethat isolatedand thosethatdidnot (2.1%vs2.0%, respectively), isolationwasassociatedwithhigher ratesofpostoperative pulmonarycomplicationsafteradjustment(adjustedOR1.20,95%CI1.05–1.36,p=0.005).Sensitivityanalyses revealednofurtherdifferenceswhenpatientswerecategorisedby:pre-operativetesting;useofCOVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increasedwithperiodsofisolationlongerthan3days,withanOR(95%CI)at4–7daysor≥8daysof1.25(1.04 1.48), p=0.015and1.31 (1.11–1.55), p=0.001, respectively. Isolationbeforeelectivesurgerymightbe associatedwithasmall but clinically important increasedriskof postoperativepulmonarycomplications. Longerperiodsofisolationshowednoreductionintheriskofpostoperativepulmonarycomplications.These findingshavesignificantimplicationsforglobalprovisionofelectivesurgicalcare.
dc.description.sponsorshipNIHRGlobalHealthResearchUnitonGlobalSurgery,Birmingham,UK
dc.identifier.issn0003-2409
dc.identifier.urihttps://uilspace.unilorin.edu.ng/handle/123456789/18520
dc.language.isoen
dc.publisherAssociation of Anaesthestetics Great Britain and Ireland.
dc.subjectSARS-Cov-2
dc.subjectCOVID-19
dc.subjectsurgery
dc.subjectpathways
dc.subjectpre-operativeisolation
dc.titleEffects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study
dc.typeArticle

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