TY  - JOUR
A1  - Arnaud, Alexis P.
A1  - Moreira de Azevedo, José
A1  - Minaya Bravo, Ana Maria
A1  - Chaudhry, Daoud
A1  - AlAmeer, Ehab
A1  - El-Boghdadly, Kariem
A1  - Elhadi, Muhammed
A1  - Emile, Sameh
A1  - Gallo, Gaetano
A1  - Glasbey, James C.
A1  - Ghosh, Dhruva
A1  - Isik, Arda
A1  - Jones, Conor S.
A1  - Leventoğlu, Sezai
A1  - Li, Elizabeth
A1  - Martin, Janet
A1  - Mohan, Helen
A1  - Nepogodiev, Dmitri
A1  - Pawar, Pranay
A1  - Smart, Neil
A1  - Pockney, Peter
A1  - Simoes, Joana F. F.
A1  - Tabiri, Stephen
A1  - Venn, Mary L.
A1  - Wright, Deborah
A1  - Bhangu, Aneel
T1  - SARS‐CoV‐2 infection and venous thromboembolism after surgery: an international prospective cohort study
T2  - Anaesthesia
N2  - SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARSCoV 2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARSCoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1–2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2–3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9–3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3–6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.
Y1  - 2022
UR  - https://opus.bibliothek.uni-augsburg.de/opus4/frontdoor/index/index/docId/123869
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:384-opus4-1238690
SN  - 0003-2409
SN  - 1365-2044
N1  - Published on behalf of the COVIDSurg Collaborative and the GlobalSurg Collaborative. Please see publisher's website for further details.
VL  - 77
IS  - 1
SP  - 28
EP  - 39
PB  - Wiley
ER  -