학술논문
Nonelective coronary artery bypass graft outcomes are adversely impacted by Coronavirus disease 2019 infection, but not altered processes of care: A National COVID Cohort Collaborative and National Surgery Quality Improvement Program analysisCentral MessagePerspective
Document Type
article
Author
Emily A. Grimsley, MD; Johnathan V. Torikashvili, BS; Haroon M. Janjua, MS; Meagan D. Read, MD; Anai N. Kothari, MD, MS; Nate B. Verhagen, BS; Ricardo Pietrobon, MD, PhD; Paul C. Kuo, MD, MS, MBA; Michael P. Rogers, MD, MS; Adam B. Wilcox; Adam M. Lee; Alexis Graves; Alfred (Jerrod) Anzalone; Amin Manna; Amit Saha; Amy Olex; Andrea Zhou; Andrew E. Williams; Andrew Southerland; Andrew T. Girvin; Anita Walden; Anjali A. Sharathkumar; Benjamin Amor; Benjamin Bates; Brian Hendricks; Brijesh Patel; Caleb Alexander; Carolyn Bramante; Cavin Ward-Caviness; Charisse Madlock-Brown; Christine Suver; Christopher Chute; Christopher Dillon; Chunlei Wu; Clare Schmitt; Cliff Takemoto; Dan Housman; Davera Gabriel; David A. Eichmann; Diego Mazzotti; Don Brown; Eilis Boudreau; Elaine Hill; Elizabeth Zampino; Emily Carlson Marti; Emily R. Pfaff; Evan French; Farrukh M. Koraishy; Federico Mariona; Fred Prior; George Sokos; Greg Martin; Harold Lehmann; Heidi Spratt; Hemalkumar Mehta; Hongfang Liu; Hythem Sidky; J.W. Awori Hayanga; Jami Pincavitch; Jaylyn Clark; Jeremy Richard Harper; Jessica Islam; Jin Ge; Joel Gagnier; Joel H. Saltz; Joel Saltz; Johanna Loomba; John Buse; Jomol Mathew; Joni L. Rutter; Julie A. McMurry; Justin Guinney; Justin Starren; Karen Crowley; Katie Rebecca Bradwell; Kellie M. Walters; Ken Wilkins; Kenneth R. Gersing; Kenrick Dwain Cato; Kimberly Murray; Kristin Kostka; Lavance Northington; Lee Allan Pyles; Leonie Misquitta; Lesley Cottrell; Lili Portilla; Mariam Deacy; Mark M. Bissell; Marshall Clark; Mary Emmett; Mary Morrison Saltz; Matvey B. Palchuk; Melissa A. Haendel; Meredith Adams; Meredith Temple-O'Connor; Michael G. Kurilla; Michele Morris; Nabeel Qureshi; Nasia Safdar; Nicole Garbarini; Noha Sharafeldin; Ofer Sadan; Patricia A. Francis; Penny Wung Burgoon; Peter Robinson; Philip R.O. Payne; Rafael Fuentes; Randeep Jawa; Rebecca Erwin-Cohen; Rena Patel; Richard A. Moffitt; Richard L. Zhu; Rishi Kamaleswaran; Robert Hurley; Robert T. Miller; Saiju Pyarajan; Sam G. Michael; Samuel Bozzette; Sandeep Mallipattu; Satyanarayana Vedula; Scott Chapman; Shawn T. O'Neil; Soko Setoguchi; Stephanie S. Hong; Steve Johnson; Tellen D. Bennett; Tiffany Callahan; Umit Topaloglu; Usman Sheikh; Valery Gordon; Vignesh Subbian; Warren A. Kibbe; Wenndy Hernandez; Will Beasley; Will Cooper; William Hillegass; Xiaohan Tanner Zhang
Source
JTCVS Open, Vol 16, Iss , Pp 342-352 (2023)
Subject
Language
English
ISSN
2666-2736
Abstract
Objective: The effects of Coronavirus disease 2019 (COVID-19) infection and altered processes of care on nonelective coronary artery bypass grafting (CABG) outcomes remain unknown. We hypothesized that patients with COVID-19 infection would have longer hospital lengths of stay and greater mortality compared with COVID-negative patients, but that these outcomes would not differ between COVID-negative and pre-COVID controls. Methods: The National COVID Cohort Collaborative 2020-2022 was queried for adult patients undergoing CABG. Patients were divided into COVID-negative, COVID-active, and COVID-convalescent groups. Pre-COVID control patients were drawn from the National Surgical Quality Improvement Program database. Adjusted analysis of the 3 COVID groups was performed via generalized linear models. Results: A total of 17,293 patients underwent nonelective CABG, including 16,252 COVID-negative, 127 COVID-active, 367 COVID-convalescent, and 2254 pre-COVID patients. Compared to pre-COVID patients, COVID-negative patients had no difference in mortality, whereas COVID-active patients experienced increased mortality. Mortality and pneumonia were higher in COVID-active patients compared to COVID-negative and COVID-convalescent patients. Adjusted analysis demonstrated that COVID-active patients had higher in-hospital mortality, 30- and 90-day mortality, and pneumonia compared to COVID-negative patients. COVID-convalescent patients had a shorter length of stay but a higher rate of renal impairment. Conclusions: Traditional care processes were altered during the COVID-19 pandemic. Our data show that nonelective CABG in patients with active COVID-19 is associated with significantly increased rates of mortality and pneumonia. The equivalent mortality in COVID-negative and pre-COVID patients suggests that pandemic-associated changes in processes of care did not impact CABG outcomes. Additional research into optimal timing of CABG after COVID infection is warranted.