目的:探讨轻度或无症状SARS-CoV-2(严重急性呼吸道综合征冠状病毒2)感染个体非急诊手术时机与确诊感染时间至手术当天术后恢复质量的关系。
方法:我们回顾性回顾了2023年1月9日至2023年2月17日在一鸡山医院接受择期全身麻醉手术的300例轻度或无症状SARS-CoV-2感染患者的病历。根据从确诊SARS-CoV-2感染到手术当天的时间,患者分为四组:≤2周(A组),2-4周(B组),4-6周(C组),和6-8周(D组)。主要结局指标包括第3天的恢复质量-15(QoR-15)量表评分,3个月,术后6个月。次要结果指标包括术后死亡率,入住ICU,肺部并发症,术后住院时间,拔管时间,是时候离开PACU了.
结果:关于主要结局指标,A组术后3天的QoR-15评分明显低于其他三组(P<0.05),其他三组间差异无统计学意义(P>0.05)。术后3个月和6个月的QoR-15评分四组比较差异无统计学意义(P>0.05)。在次要结果指标方面,A组较其他三组住院时间明显延长(P<0.05),其他结局指标差异无统计学意义(P>0.05)。
结论:轻度或无症状的SARS-CoV-2感染患者的手术时机不影响长期恢复质量,但影响短期恢复质量。特别是对于确诊感染后2周内的择期全身麻醉手术。因此,建议等待至少大于2周的手术时机,以改善短期恢复质量并提高患者预后.
OBJECTIVE: To explore the relationship between the timing of non-emergency surgery in mild or asymptomatic SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infected individuals and the quality of postoperative recovery from the time of confirmed infection to the day of surgery.
METHODS: We retrospectively reviewed the medical records of 300 cases of mild or asymptomatic SARS-CoV-2 infected patients undergoing elective general anaesthesia surgery at Yijishan Hospital between January 9, 2023, and February 17, 2023. Based on the time from confirmed SARS-CoV-2 infection to the day of surgery, patients were divided into four groups: ≤2 weeks (Group A), 2-4 weeks (Group B), 4-6 weeks (Group C), and 6-8 weeks (Group D). The primary outcome measures included the Quality of Recovery-15 (QoR-15) scale scores at 3 days, 3 months, and 6 months postoperatively. Secondary outcome measures included postoperative mortality, ICU admission, pulmonary complications, postoperative length of hospital stay, extubation time, and time to leave the PACU.
RESULTS: Concerning the primary outcome measures, the QoR-15 scores at 3 days postoperatively in Group A were significantly lower compared to the other three groups (P < 0.05), while there were no statistically significant differences among the other three groups (P > 0.05). The QoR-15 scores at 3 and 6 months postoperatively showed no statistically significant differences among the four groups (P > 0.05). In terms of secondary outcome measures, Group A had a significantly prolonged hospital stay compared to the other three groups (P < 0.05), while other outcome measures showed no statistically significant differences (P > 0.05).
CONCLUSIONS: The timing of surgery in mild or asymptomatic SARS-CoV-2 infected patients does not affect long-term recovery quality but does impact short-term recovery quality, especially for elective general anaesthesia surgeries within 2 weeks of confirmed infection. Therefore, it is recommended to wait for a surgical timing of at least greater than 2 weeks to improve short-term recovery quality and enhance patient prognosis.