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Probability of death during surgery much greater for patients with coronavirus

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13 October 2020

The risk of dying is four times higher for patients infected with the coronavirus than for non-infected patients that have to undergo surgery, according to a large-scale national research study led by the UMCG. Twenty-four Dutch healthcare institutions participated in the study. The research results were recently published in the academic journal Surgery.

‘This information is extremely important for surgeons and patients when it comes to making decisions regarding non-urgent care’, says UMCG surgeon and research leader Schelto Kruijff. ‘Sometimes surgery is essential and you have no choice. But if there are alternatives instead of surgery or if it’s possible to postpone the surgery, it’s important to make that choice based on the exact data and risks.’

Higher mortality rate and more complications

The research was based on the data of 503 patients who have undergone surgery in one of the participating Dutch hospitals over the past few months. Information about the patients, the surgeries and the outcomes were collected. Through preoperative testing, it was established whether a patient was infected with COVID-19 (SARS-CoV-2). It was a conscious decision to create a large control group with patients who were demonstrably not infected so that a good comparison of the risks could be made. In the group of patients with COVID-19, the mortality rate was 16%, as opposed to 4% in the non-infected control group. There were also more postoperative complications in the group infected with the novel coronavirus.

The mortality rate of 4% among patients without COVID-19 is twice as high as the mortality rate before the pandemic. ‘This can be explained by the fact that the research was conducted during the first stages of the coronavirus pandemic, when only the most urgent surgeries took place’, Kruijff says.

Research into consequences of postponing surgeries

The national CovidSurg research group is now going on to analyse the consequences of postponing several treatments and surgeries during the first wave. Now that the second wave has arrived, it is important to gain insight into these consequences as soon as possible. In collaboration with the Dutch Institute for Clinical Auditing – responsible for the quality registration of surgeries in the Netherlands – a COVID-19 module has been developed. ‘This will enable us to make a good comparison between the quality of surgeries in this year and in previous years’, says Kruijff. ‘This is important when it comes to making solid protocols for the current pandemic but also for comparable pandemics in the future.’ The first results are expected mid-November.

Read the study here.