Cardiac surgery outcome during the COVID-19 pandemic: a retrospective review of the early experience in nine UK centres

Journal of Cardiothoracic Surgery

Dumbor Ngaage¹  Metesh Acharya²  Enoch Akowuah³  Simon Kendall³  Mazyar Kanani³  Bilal H. Kirmani⁴  George Krasopoulos⁵  Reuben Jeganathan⁶  Indu Deglurkar⁷  Patrick Yiu⁸  Aung Ye Oo⁹  Julie Sanders⁹  Jackie Cooper^1,10 

[1] Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull, UK;Department of Cardiothoracic Surgery, Glenfield Hospital, University Hospitals Leicester NHS Foundation Trust, Leicester, UK;Department of Cardiothoracic Surgery, James Cook University Hospital, South Tees NHS Foundation Trust, Middlesbrough, UK;Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK;Department of Cardiothoracic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK;Department of Cardiothoracic Surgery, Royal Victoria Hospital, Belfast, Northern Ireland, UK;Department of Cardiothoracic Surgery, University Hospital of Wales, Cardiff, Wales, UK;Heart and Lung Centre, New Cross Hospital, Wolverhampton, UK;St Bartholomew’s Hospital, Barts Health NHS Trust, EC1A 7DN, London, UK;William Harvey Research Institute, Queen Mary University of London, London, UK;William Harvey Research Institute, Queen Mary University of London, London, UK;

关键词: Covid-19;    Cardiac surgery;    Mortality;    Outcomes;   

DOI  :  10.1186/s13019-021-01424-y

来源: Springer

【 摘 要 】

BackgroundEarly studies conclude patients with Covid-19 have a high risk of death, but no studies specifically explore cardiac surgery outcome. We investigate UK cardiac surgery outcomes during the early phase of the Covid-19 pandemic.MethodsThis retrospective observational study included all adult patients undergoing cardiac surgery between 1st March and 30th April 2020 in nine UK centres. Data was obtained and linked locally from the National Institute for Cardiovascular Outcomes Research Adult Cardiac Surgery database, the Intensive Care National Audit and Research Centre database and local electronic systems. The anonymised datasets were analysed by the lead centre. Statistical analysis included descriptive statistics, propensity score matching (PSM), conditional logistic regression and hierarchical quantile regression.ResultsOf 755 included individuals, 53 (7.0%) had Covid-19. Comparing those with and without Covid-19, those with Covid-19 had increased mortality (24.5% v 3.5%, p < 0.0001) and longer post-operative stay (11 days v 6 days, p = 0.001), both of which remained significant after PSM. Patients with a pre-operative Covid-19 diagnosis recovered in a similar way to non-Covid-19 patients. However, those with a post-operative Covid-19 diagnosis remained in hospital for an additional 5 days (12 days v 7 days, p = 0.024) and had a considerably higher mortality rate compared to those with a pre-operative diagnosis (37.1% v 0.0%, p = 0.005).ConclusionsTo mitigate against the risks of Covid-19, particularly the post-operative burden, robust and effective pre-surgery diagnosis protocols alongside effective strategies to maintain a Covid-19 free environment are needed. Dedicated cardiac surgery hubs could be valuable in achieving safe and continual delivery of cardiac surgery.

【 授权许可】

CC BY