Outcomes after surgery in patients with and without recent influenza: a nationwide population-based study

Fai Lam; Chien-Chang Liao; Ta-Liang Chen; Yu-Min Huang; Yuarn-Jang Lee; Hung-Yi Chiou

doi:10.3389/fmed.2023.1117885

Outcomes after surgery in patients with and without recent influenza: a nationwide population-based study

Front Med (Lausanne). 2023 Jun 9:10:1117885. doi: 10.3389/fmed.2023.1117885. eCollection 2023.

Authors

Fai Lam^{1

2}, Chien-Chang Liao^{2

3

4

5

6}, Ta-Liang Chen^{3

4

7}, Yu-Min Huang^{8

9}, Yuarn-Jang Lee¹⁰, Hung-Yi Chiou^{1

11}

Affiliations

¹ School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
² Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan.
³ Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁴ Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
⁵ Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
⁶ School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
⁷ Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
⁸ Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁹ Division of Gastrointestinal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
¹⁰ Division of Infectious Disease, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan.
¹¹ Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.

Abstract

Background: The influence of recent influenza infection on perioperative outcomes is not completely understood.

Method: Using Taiwan's National Health Insurance Research Data from 2008 to 2013, we conducted a surgical cohort study, which included 20,544 matched patients with a recent history of influenza and 10,272 matched patients without. The main outcomes were postoperative complications and mortality. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for the complications and for mortality in patients with a history of influenza within 1-14 days or 15-30 days compared with non-influenza controls.

Results: Compared with patients who had no influenza, patients with influenza within preoperative days 1-7 had increased risks of postoperative pneumonia (OR 2.22, 95% CI 1.81-2.73), septicemia (OR 1.98, 95% CI 1.70-2.31), acute renal failure (OR 2.10, 95% CI 1.47-3.00), and urinary tract infection (OR 1.45, 95% CI 1.23-1.70). An increased risk of intensive care admission, prolonged length of stay, and higher medical expenditure was noted in patients with history of influenza within 1-14 days.

Conclusion: We found that there was an association between influenza within 14 days preoperatively and the increased risk of postoperative complications, particularly with the occurrence of influenza within 7 days prior to surgery.

Keywords: infectious diseases; influenza; mortality; perioperative outcomes; surgery.