Table 3.
Multilevel model of association between pulmonary complications, SARS-COV-2 infection, and 30-day postoperative mortality in elective abdominal cancer surgery
| 30-day postoperative mortality |
Univariable analysis |
Multilevel analysis |
||||
|---|---|---|---|---|---|---|
| Died | Alive | Odds ratio * | P | Odds ratio * | P | |
| 30-day pulmonary complication | ||||||
| No | 51 (0.7) | 6861 (99.3) | 1.00 (reference) | 1.00 (reference) | ||
| Yes (Non-COVID) | 25 (6.4) | 365 (93.6) | 9.21 (5.56, 14.89) | < 0.001 | 6.91 (3.71, 12.89) | < 0.001 |
| Yes (COVID) | 31 (31.0) | 69 (69.0) | 60.44 (36.24, 99.91) | < 0.001 | 53.74 (23.33, 123.80) | < 0.001 |
| Age (years) | ||||||
| < 60 | 11 (0.5) | 2270 (99.5) | 1.00 (reference) | 1.00 (reference) | ||
| 60–69 | 26 (1.2) | 2187 (98.8) | 2.45 (1.24, 5.19) | 0.013 | 2.39 (0.99, 5.78) | 0.052 |
| > 70 | 70 (2.4) | 2838 (97.6) | 5.09 (2.81, 10.18) | < 0.001 | 3.77 (1.60, 8.86) | 0.002 |
| Sex | ||||||
| F | 34 (0.9) | 3610 (99.1) | 1.00 (reference) | 1.00 (reference) | ||
| M | 73 (1.9) | 3685 (98.1) | 2.10 (1.41, 3.20) | < 0.001 | 1.38 (0.81, 2.34) | 0.241 |
| ASA grade | ||||||
| I–II | 48 (1.0) | 4913 (99.0) | 1.00 (reference) | 1.00 (reference) | ||
| III–V | 59 (2.6) | 2171 (97.4) | 2.78 (1.90, 4.10) | < 0.001 | 2.11 (1.23, 3.64) | 0.007 |
| Obese (BMI ≥ 30 kg/m2) | ||||||
| No | 73 (1.5) | 4917 (98.5) | 1.00 (reference) | 1.00 (reference) | ||
| Yes | 20 (1.1) | 1798 (98.9) | 0.75 (0.44, 1.21) | 0.255 | 0.68 (0.37, 1.24) | 0.203 |
| Smoker | ||||||
| Not current | 92 (1.4) | 6569 (98.6) | 1.00 (reference) | 1.00 (reference) | ||
| Current | 15 (2.0) | 726 (98.0) | 1.48 (0.82, 2.48) | 0.167 | 1.40 (0.69, 2.85) | 0.353 |
| Chronic lung disease | ||||||
| No | 92 (1.4) | 6361 (98.6) | 1.00 (reference) | 1.00 (reference) | ||
| Yes | 15 (1.6) | 934 (98.4) | 1.11 (0.62, 1.87) | 0.709 | 0.76 (0.38, 1.54) | 0.453 |
| Cardiovascular disease | ||||||
| No | 38 (0.9) | 4004 (99.1) | 1.00 (reference) | 1.00 (reference) | ||
| Yes | 69 (2.1) | 3291 (97.9) | 2.21 (1.49, 3.32) | < 0.001 | 1.32 (0.77, 2.28) | 0.317 |
| Diabetes mellitus | ||||||
| No | 73 (1.2) | 6095 (98.8) | 1.00 (reference) | 1.00 (reference) | ||
| Yes | 34 (2.8) | 1200 (97.2) | 2.37 (1.55, 3.54) | < 0.001 | 1.94 (1.10, 3.40) | 0.021 |
| Operative approach | ||||||
| Minimally invasive | 21 (0.6) | 3749 (99.4) | 1.00 (reference) | 1.00 (reference) | ||
| Open | 86 (2.4) | 3543 (97.6) | 4.33 (2.74, 7.18) | < 0.001 | 5.40 (2.85, 10.25) | < 0.001 |
| Operative site | ||||||
| Lower abdominal | 66 (1.1) | 5791 (98.9) | 1.00 (reference) | 1.00 (reference) | ||
| Upper abdominal | 27 (2.1) | 1280 (97.9) | 1.85 (1.16, 2.87) | 0.008 | 0.55 (0.25, 1.23) | 0.144 |
| Thoracoabdominal | 14 (5.9) | 224 (94.1) | 5.48 (2.92, 9.62) | < 0.001 | 1.53 (0.55, 4.31) | 0.416 |
| Operative complexity | ||||||
| Intermediate/major | 55 (1.1) | 5039 (98.9) | 1.00 (reference) | 1.00 (reference) | ||
| Complex major | 52 (2.3) | 2256 (97.7) | 2.11 (1.44, 3.10) | < 0.001 | 1.65 (0.83, 3.31) | 0.155 |
Values in parentheses are percentages unless indicated otherwise.
*
Values in parentheses are 95 per cent confidence intervals. SARS-COV-2, severe acute respiratory syndrome coronavirus 2. Number in model = 6644, number of groups = 493, Akaike information criterion = 756.6, C-statistic = 0.961.