Ayşenur Sümer Coşkun, Şenay Öztürk Durmaz

COVID-19 ENFEKTE HASTALARDA CERRAHİ OPERASYONLAR, PROGNOZ-MORTALİTE DEĞERLENDİRMESİ

Amaç: Pandeminin başlangıcından bu yana çeşitli makalelerde SARSCoV- 2 ile enfekte hastaların cerrahisinde olumsuz sonuçlar bildirilmiştir. Ancak sayıların yetersizliği ve vaka çeşitliliği açısından yeni verilere ihtiyaç duyul- maktadır. Bu çalışmanın amacı, perioperatif dönemde SARSCoV-2 ile en- fekte hastaların, ameliyat sonrası prognozlarını bildirmektir. Yöntemler: Ameliyat geçirmiş bireylerde, ameliyattan 14 gün öncesine veya ameliyattan 14 gün sonrasına kadar nazofarengeal sürüntülerinde Po- limeraz Zincir Reaksiyonu (PCR) ile COVID-19 (+) oldukları tespit edilen veya temas öyküsü bulunup semptomları olan ya da çekilen toraks tomog- rafilerinde COVID-19 bulgusu saptanan hastalar çalışmaya dahil edildi. Hastaların demografik verileri, PCR test sonuçları, toraks tomografi bulgu- ları, ASA skorları, ek hastalıkları, cerrahi tipi, operasyon süreleri, anestezi türü, hastaların taburculuk günü ve yoğun bakım/servis yatış günleri hasta dosyaları ve elektronik kayıtlardan elde edildi. Bulgular: Hastanemizde toplam 3093 hasta opere edilmiştir. Bu hastalar- dan 40’ı kesin veya olası COVID-19 olarak çalışmaya dahil edildi. Opere edilen 40 hastadan 5’i (%12,5) operasyon sonrası dönemde eksitus ol- muştur. Eksitus olan hastaların yaş ortalaması 69,6 idi. Ölen hastalarda 4’ü (%80) erkek, 1’i (%20) kadın cinsiyetinde idi. Ölen hastaların 4’ünde eşlik eden hastalıklar mevcuttu. Hiçbir ameliyathane çalışanı cerrahi geçiren bu hastalarla ilişkili COVID-19 enfeksiyonu geçirmemiştir. Sonuç: Hastanemizde SARSCoV-2 ile enfekte hastaların cerrahi sonrası ölüm oranlarının literatürden biraz daha düşük olduğunu saptadık. Çalış- mamızdan elde edilen veriler ışığında, acil cerrahi vakalar dışında elektif vakalar ertelenmelidir. Erkek cinsiyet, ileri yaş, 2 veya daha fazla eşlik eden hastalığın varlığı, COVID-19 (+) hastalarda ameliyat sonrası olumsuz so- nuçlar için risk faktörleridir.

SURGICAL OPERATIONS IN COVID-19 INFECTED PATIENTS, ASSESSMENT OF PROGNOSIS-MORTALITY

Aim: Since the beginning of the pandemic, several articles have reported negative results in the surgery of patients infected with COVID-19. How- ever, new data are required with respect to insufficient numbers and case diversity. The aim of the current study is to report the prognosis of COVID- 19 patients in the perioperative period following the operation. Methods: In individuals who had undergone surgery, patients who were found to have COVID-19 by Polymerase Chain Reaction (PCR) on their nasopharyngeal swabs up to 14 days before or 14 days after surgery, or who had contact history and symptoms, or those with symptoms of COVID- 19 in their thoracic tomography, were included in the study. The data of the patients were obtained from patient files and digital records. Results: A total of 3093 patients were operated; 40 of these patients were included in the study as COVID-19 (+) or COVID-19 suspect; 5 (12.5%) of the 40 operated patients died in the postoperative period. The average age of the patients who died was 69.6 years old. Of the patients who died, 4 (80%) were male and 1 (20%) was female. Comorbid diseases were pre- sent in 4 of the patients who died. None of the operating suite employees experienced COVID-19 infection associated with these patients who un- derwent surgery. Conclusions: We found that the postoperative mortality rate of patients infected with COVID-19 in our hospital is slightly lower than the reported rate in the literature. Elective cases should be postponed, except for emer- gency surgical cases. Male gender, advanced age, presence of 2 or more comorbidities are risk factors for adverse postoperative outcomes in COVID-19(+) patients.

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