tetano
Editor, Senior Moderator
J Korean Med Sci
. 2023 Dec 4;38(47):e349.
doi: 10.3346/jkms.2023.38.e349. Perioperative Respiratory-Adverse Events Following General Anesthesia Among Pediatric Patients After COVID-19
Jung-Bin Park[SUP] 1 [/SUP], Jin Young Sohn[SUP] 1 [/SUP], Pyoyoon Kang[SUP] 1 [/SUP], Sang-Hwan Ji[SUP] 1 [/SUP], Eun-Hee Kim[SUP] 1 [/SUP], Ji-Hyun Lee[SUP] 1 [/SUP], Jin-Tae Kim[SUP] 1 [/SUP], Hee-Soo Kim[SUP] 1 [/SUP], Young-Eun Jang[SUP] 2 [/SUP]
Affiliations
Background: The perianesthetic morbidity, mortality risk and anesthesia-associated risk after preoperative coronavirus disease 2019 (COVID-19) omicron variant in pediatric patients have not been fully demonstrated. We examined the association between preoperative COVID-19 omicron diagnosis and the incidence of overall perioperative adverse events in pediatric patients who received general anesthesia.
Methods: This retrospective study included patients aged < 18 years who received general anesthesia between February 1 and June 10, 2022, in a single tertiary pediatric hospital. They were divided into two groups; patients in a COVID-19 group were matched to patients in a non-COVID-19 group during the omicron-predominant period in Korea. Data on patient characteristics, anesthesia records, post-anesthesia records, COVID-19-related history, symptoms, and mortality were collected. The primary outcomes were the overall perioperative adverse events, including perioperative respiratory adverse events (PRAEs), escalation of care, and mortality.
Results: In total, 992 patients were included in the data analysis (n = 496, COVID-19; n = 496, non-COVID-19) after matching. The overall incidence of perioperative adverse events was significantly higher in the COVID-19 group than in the non-COVID-19 group (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.89-1.94). The difference was significant for PRAEs (OR, 2.00; 95% CI, 1.96-2.02) but not in escalation of care or mortality. The most pronounced difference between the two groups was observed in instances of high peak inspiratory pressure ≥ 25 cmH[SUB]2[/SUB]O during the intraoperative period (OR, 11.0; 95% CI, 10.5-11.4). Compared with the non-COVID-19 group, the risk of overall perioperative adverse events was higher in the COVID-19 group diagnosed 0-2 weeks before anesthesia (OR, 6.5; 95% CI, 2.1-20.4) or symptomatic on the anesthesia day (OR, 6.4; 95% CI, 3.30-12.4).
Conclusion: Pediatric patients with the preoperative COVID-19 omicron variant had increased risk of PRAEs. Patients within 2 weeks after COVID-19 or those with symptoms had a higher risk of PRAEs.
Keywords: COVID-19; Children; Desaturation; General Anesthesia; Omicron; Perioperative Respiratory Adverse Event; Upper Respiratory Infection.
. 2023 Dec 4;38(47):e349.
doi: 10.3346/jkms.2023.38.e349. Perioperative Respiratory-Adverse Events Following General Anesthesia Among Pediatric Patients After COVID-19
Jung-Bin Park[SUP] 1 [/SUP], Jin Young Sohn[SUP] 1 [/SUP], Pyoyoon Kang[SUP] 1 [/SUP], Sang-Hwan Ji[SUP] 1 [/SUP], Eun-Hee Kim[SUP] 1 [/SUP], Ji-Hyun Lee[SUP] 1 [/SUP], Jin-Tae Kim[SUP] 1 [/SUP], Hee-Soo Kim[SUP] 1 [/SUP], Young-Eun Jang[SUP] 2 [/SUP]
Affiliations
- PMID: 38050910
- DOI: 10.3346/jkms.2023.38.e349
Background: The perianesthetic morbidity, mortality risk and anesthesia-associated risk after preoperative coronavirus disease 2019 (COVID-19) omicron variant in pediatric patients have not been fully demonstrated. We examined the association between preoperative COVID-19 omicron diagnosis and the incidence of overall perioperative adverse events in pediatric patients who received general anesthesia.
Methods: This retrospective study included patients aged < 18 years who received general anesthesia between February 1 and June 10, 2022, in a single tertiary pediatric hospital. They were divided into two groups; patients in a COVID-19 group were matched to patients in a non-COVID-19 group during the omicron-predominant period in Korea. Data on patient characteristics, anesthesia records, post-anesthesia records, COVID-19-related history, symptoms, and mortality were collected. The primary outcomes were the overall perioperative adverse events, including perioperative respiratory adverse events (PRAEs), escalation of care, and mortality.
Results: In total, 992 patients were included in the data analysis (n = 496, COVID-19; n = 496, non-COVID-19) after matching. The overall incidence of perioperative adverse events was significantly higher in the COVID-19 group than in the non-COVID-19 group (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.89-1.94). The difference was significant for PRAEs (OR, 2.00; 95% CI, 1.96-2.02) but not in escalation of care or mortality. The most pronounced difference between the two groups was observed in instances of high peak inspiratory pressure ≥ 25 cmH[SUB]2[/SUB]O during the intraoperative period (OR, 11.0; 95% CI, 10.5-11.4). Compared with the non-COVID-19 group, the risk of overall perioperative adverse events was higher in the COVID-19 group diagnosed 0-2 weeks before anesthesia (OR, 6.5; 95% CI, 2.1-20.4) or symptomatic on the anesthesia day (OR, 6.4; 95% CI, 3.30-12.4).
Conclusion: Pediatric patients with the preoperative COVID-19 omicron variant had increased risk of PRAEs. Patients within 2 weeks after COVID-19 or those with symptoms had a higher risk of PRAEs.
Keywords: COVID-19; Children; Desaturation; General Anesthesia; Omicron; Perioperative Respiratory Adverse Event; Upper Respiratory Infection.