Evidence map›Paper›PMID 34225188›Full record

ArticleJournal of clinical anesthesia2021

Increased incidence of post-operative respiratory failure in patients with pre-operative SARS-CoV-2 infection.

Michael E Kiyatkin, Samantha P Levine, Atsumi Kimura, Ryan W Linzer, Jacqueline R Labins, Joseph I Kim, Aryeh Gurvich, Michelle N Gong

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical anesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Observational
  2. Observational
  3. Observational
  4. Article
  5. Article
  6. Article
  7. The unseen pandemic: treatment delays and loss to follow-up due to fear of COVID.Journal of anesthesia, analgesia and critical care · 2022
    Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Michael E KiyatkinDepartment of Anesthesiology, Montefiore Medical Center, Bronx, NY, USA; Department of Medicine, Montefiore Medical Center, Bronx, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USA. Electronic address: mkiyatkin@montefiore.org.
Samantha P LevineAlbert Einstein College of Medicine, Bronx, NY, USA.
Atsumi KimuraAlbert Einstein College of Medicine, Bronx, NY, USA.
Ryan W LinzerAlbert Einstein College of Medicine, Bronx, NY, USA.
Jacqueline R LabinsAlbert Einstein College of Medicine, Bronx, NY, USA.
Joseph I KimAlbert Einstein College of Medicine, Bronx, NY, USA.
Aryeh GurvichAlbert Einstein College of Medicine, Bronx, NY, USA.
Michelle N GongDepartment of Medicine, Montefiore Medical Center, Bronx, NY, USA.

Funding

CTSA Administrative Supplement for Informatics Core: A novel AI/ML system to predict respiratory failure and ARDS in Covid-19 patientsUL1TR002556 · NCATS · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI KELLER, MARLA J, KIM, MIMI Y · 2018 to 2022
$26.7M
NCATS NIH HHS UL1 TR002556
6 · The paper itself

Abstract

objectiveWhile studies have reported increased post-operative pulmonary complications with SARS-CoV-2 infection, many are limited by use of historical controls or focus on less severe respiratory complications. We characterized the association between pre-operative SARS-CoV-2 infection and post-operative respiratory failure (PORF). DESIGN AND

settingThis was a single center retrospective cohort study in New York City between March 14-June 14, 2020. PATIENTS: Exclusion criteria were age < 18-years, obstetric procedures, absence of SARS-CoV-2 PCR testing, and pre-operative respiratory failure. A total of 778 patients met criteria, of which 87 had SARS-CoV-2. MEASUREMENTS: The primary outcome, PORF, included inability to extubate for ≥24 h or unplanned re-intubation within 5 days. Multiple exposures were measured including SARS-CoV-2 infection 4 weeks before or 5 days after surgery. Multivariable logistic regression was performed to adjust for pre-operative hypoxemia, oxygen use, and pneumonia as well as tachycardia, gender, Charlson Comorbidity Index (CCI), Surgical Mortality Probability Model (S-MPM) index, and peri-operative blood transfusion. MAIN

resultsSARS-CoV patients had higher CCI (P = 0.007) and S-MPM scores (P = 0.02). The incidence of PORF was 16% versus 7% in uninfected comparators (P = 0.001). Amongst infected individuals, 39% exhibited symptoms of COVID-19 and PORF was more common in these patients compared to asymptomatic individuals (26% vs. 9%, P = 0.04). Adjusted analysis revealed increased odds of PORF with infection (OR 2.8, 95% CI 1.2-6.2). This persisted even when adjusting for probable mediators such as pre-operative hypoxemia. Infected patients also demonstrated increased adjusted odds of 30-day mortality (OR 3.5, 95% CI 1.4-9.1).

conclusionsDetection of SARS-CoV-2 infection within 4 weeks before or 5 days after surgery is associated with increased odds of 5-day PORF and 30-day mortality. This supports delaying elective surgery, but questions remain regarding the applicability of this recommendation for asymptomatic patients needing urgent or semi-urgent procedures such as oncologic surgery.

Indexed as

COVID-19Respiratory InsufficiencyAdolescentFemaleHumansIncidencePregnancyRetrospective StudiesSARS-CoV-2Coronavirus disease 2019 (COVID-19)Invasive mechanical ventilationPerioperative carePneumoniaPost-operative respiratory failureSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Identifiers

PMID34225188
PMCPMC8216857

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.