Outcomes after emergency abdominal surgery in COVID-19 patients at a referral center in Brazil

Updates Surg. 2021 Apr;73(2):763-768. doi: 10.1007/s13304-021-01007-5. Epub 2021 Feb 24.

Abstract

Purpose: COVID-19 is associated with high morbidity and mortality in patients undergoing surgery. Contrary to elective procedures, emergency operations should not be postponed. We aim to evaluate the profile and outcomes of COVID-19 patients who underwent emergency abdominal surgery.

Methods: We performed a retrospective analysis of perioperative data of COVID-19 patients undergoing emergency surgery from April 2020 to August 2020.

Results: Eighty-two patients were evaluated due to abdominal complaints, yielding 22 emergency surgeries. The mean APACHE II and SAPS were 18.7 and 68, respectively. Six patients had a PaO2/FiO2 lower than 200 and more than 50% of parenchymal compromise on chest tomography. The most common indications for emergency surgery were hernias (6; 27.2%). The median length of stay was 30 days, and only two patients required reoperation. Postoperatively, 10 (43.3%) patients needed mechanical ventilation for a mean of 6 days. The overall mortality rate was 31.8%.

Conclusion: Both postoperative morbidity and mortality are high in COVID-19 patients with respiratory compromise and abdominal emergencies.

Keywords: Abdominal surgery; Acute abdomen; COVID-19; Emergency surgery; Laparoscopy; SARS-CoV-2.

MeSH terms

  • APACHE
  • Abdomen, Acute / mortality
  • Abdomen, Acute / surgery*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brazil / epidemiology
  • COVID-19 / complications*
  • COVID-19 / mortality
  • Emergencies
  • Female
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / virology
  • Respiration, Artificial
  • Retrospective Studies
  • SARS-CoV-2