Background During the COVID-19 crisis it was necessary to generate a specific care network and reconvert operating rooms to attend emergency and high-acuity patients undergoing complex surgery. The aim of this study is to classify postoperative complications and mortality and to assess the impact that the COVID-19 pandemic may have had on the results. Methods this is a non-inferiority retrospective observational study. Two different groups of surgical patients were created: Pre-pandemic COVID and Pandemic COVID. Severity of illness was rated according to the Diagnosis-related Groups (DRG) score. Comparisons were made between groups and between DRG severity score-matched samples. Non-inferiority was set at up to 10 % difference for grade III to V complications according to the Clavien-Dindo classification, and up to 2 % difference in mortality. Results A total of 1649 patients in the PreCOVID group and 763 patients in the COVID group were analysed; 371 patients were matched for DRG severity score 3-4 (236 preCOVID and 135 COVID). No differences were found in relation to re-operation (22.5 % vs. 21.5 %) or late admission to critical care unit (5.1 % vs. 4.5 %). Clavien grade III to V complications occurred in 107 patients (45.3 %) in the PreCOVID group and in 56 patients (41.5 %) in the COVID group, and mortality was 12.7 % and 12.6 %, respectively. During the pandemic, 3 % of patients tested positive for Covid-19 on PCR: 12 patients undergoing elective surgery and 11 emergency surgery; there were 5 deaths, 3 of which were due to respiratory failure following Covid-19-induced pneumonia. Conclusions Although this study has some limitations, it has shown the non-inferiority of surgical outcomes during the COVID pandemic, and indicates that resuming elective surgery is safe. Trial registration Clinicaltrials.gov identifier: NCT04780594 . Supplementary Information The online version contains supplementary material available at 10.1186/s12871-021-01495-3.
【저자키워드】 Mortality, Elective surgery, Emergent surgery, SARS-CoV-2 (COVID19) pandemic, Clavien-Dindo complications, 【초록키워드】 pandemic, Critical care, Respiratory failure, Pneumonia, COVID-19 pandemic, severity, surgical, outcome, Operating room, COVID, non-inferiority, Patient, Complication, group, Admission, Care, retrospective, deaths, Safe, severity of illness, COVID-19 crisis, supplementary material, complex, positive, limitations, Result, shown, tested, occurred, generate, indicate, postoperative, 【제목키워드】 COVID19, pandemic, Impact, non-inferiority, Patient, morbidity and mortality, retrospective, high risk, the SARS-CoV-2,