Key result
Preoperative COVID-19 screening is linked to longer wait times but fails to reduce 30-day mortality.
Why the study?
The impact of preoperative COVID-19 RT-PCR screening waiting time on outcomes of acute type A aortic dissection emergency surgery was unclear.
Does the waiting time associated with preoperative COVID-19 RT-PCR screening worsen outcomes in patients undergoing emergency surgery for acute type A aortic dissection?
Cohort (n=214)
No
Does the waiting time associated with preoperative COVID-19 RT-PCR screening worsen outcomes in patients undergoing emergency surgery for acute type A aortic dissection?
Absolute Event Rate: 2.8% vs 12.4%
Preoperative COVID-19 screening increases waiting time for emergency type A aortic dissection surgery but does not adversely affect preoperative ruptures, postoperative complications, or 30-day mortality.
BACKGROUND: Since November 2020, all patients undergoing emergency surgery at our hospital have been subjected to preoperative reverse transcription polymerase chain reaction (RT-PCR) screening to prevent nosocomial COVID-19 infection, with admission to the operating room requiring a negative result. Herein, we compared the pre- and postoperative outcomes of acute type A aortic dissection surgery before and after implementing the RT-PCR screening for all patients. METHODS: We compared the postoperative results of 105 patients who underwent acute type A aortic dissection emergency surgery from January 2019 to October 2020 (Group I) and 109 patients who underwent the surgery following RT-PCR screening from November 2020 to March 2022 (Group II). RESULTS: The average waiting time from arrival at the hospital to admission to the operating room was 36 and 81 min in Groups I and II, respectively. Ruptured cardiac tamponade was observed preoperatively in 26.6% and 21.1% of Groups I and II patients, respectively. The preoperative waiting time due to RT-PCR screening did not contribute to the cardiac tamponade. Surgical complications such as bleeding (reopened chest), respiratory failure, cerebral neuropathy, or mediastinitis did not increase significantly. The number of deaths 30 days after surgery (Group I = 13 and Group II = 3) showed no significant difference between the groups. There were no cases of nosocomial COVID-19 infections. CONCLUSIONS: Preoperative COVID-19 screening is an important method to prevent nosocomial infections. The associated waiting time did not affect the number of preoperative ruptures or affect postoperative complications or mortality.
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Hishikawa et al. (2022) conducted a cohort in Acute type A aortic dissection (n=214). Preoperative RT-PCR screening for COVID-19 vs. No preoperative RT-PCR screening was evaluated on 30-day mortality. Preoperative COVID-19 RT-PCR screening increased waiting time but did not significantly affect 30-day mortality (2.8% vs 12.4%) or preoperative ruptured cardiac tamponade (21.1% vs 26.6%).
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