Henry Hoang, Erik Romanelli, Felix Borngaesser, Ibraheem M Karaye, Joseph Derose, Daniel J Goldstein, Bilal Tufail, Danielle Nogoy, Matthias Eikermann, Jonathan Leff
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引用次数: 0
Abstract
Objective: To investigate the association between preoperative Coronavirus disease 2019 (COVID-19) infection and complications in patients undergoing coronary artery bypass grafting (CABG), focusing on the timing of infection.
Design: A retrospective cohort study using the National Covid Cohort Collaborative (N3C) database SETTING: Multi-institutional data from the National COVID Cohort Collaborative, representing diverse US healthcare settings PARTICIPANTS: Adult patients undergoing CABG during the COVID-19 pandemic, identified through CPT codes. COVID-19 infection timing was stratified into 3 groups: 0 to 2 weeks, 2 to 6 weeks, and 6 to 12 weeks before surgery. Outcomes were analyzed based on the timing of COVID-19 infection and compared to patients without a history of COVID-19.
Interventions: No direct interventions were performed. Outcomes were analyzed based on the timing of COVID-19 infection.
Measurements and main results: Postoperative complications were assessed using International Classification of Disease, Tenth Revision codes, including venous thromboembolism (VTE), sepsis, acute kidney injury, surgical site infection, acute myocardial infarction (AMI), 30-day mortality, and 1-year mortality. For COVID-19 infection occurring within 0 to 2 weeks before surgery, significantly increased odds were observed for VTE (odds ratio [OR], 2.29; 95% confidence interval [CI], 1.36-3.59]; p = 0.001), sepsis (OR, 1.74; 95% CI, 1.01-2.81; p = 0.032), 30-day mortality (OR, 3.60; 95% CI, 2.32-5.35; p < 0.0001), and 1-year mortality (OR, 3.10; 95% CI, 2.24-4.21; p < 0.0001), with no significant associations for surgical site infection (OR, .94; 95% CI, 0.48-1.64; p = 0.849), or AMI (OR, 1.21; 95% CI, 0.84-1.69; p = 0.274) compared to COVID-19-negative patients.
Conclusions: COVID-19 infection within 2 weeks before CABG is associated with a significantly increased risk of complications. Further research is needed to understand the mechanisms and optimize care for these patients.
期刊介绍：
The Journal of Cardiothoracic and Vascular Anesthesia is primarily aimed at anesthesiologists who deal with patients undergoing cardiac, thoracic or vascular surgical procedures. JCVA features a multidisciplinary approach, with contributions from cardiac, vascular and thoracic surgeons, cardiologists, and other related specialists. Emphasis is placed on rapid publication of clinically relevant material.
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