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COVID-19 大流行对心脏手术患者并发症和死亡率的影响。

Effect of the COVID-19 pandemic on complications and mortality of patients with cardiac surgery.

机构信息

Department of Cardiovascular Surgery, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, People's Republic of China.

Department of Emergency Internal Medicine, Shaanxi Provincial People's Hospital, 256 Youyi West Road, Xi'an, 710068, People's Republic of China.

出版信息

J Cardiothorac Surg. 2021 Dec 31;16(1):361. doi: 10.1186/s13019-021-01744-z.

Abstract

OBJECTIVES

The purpose of this study was to assess changes in cardiovascular disease severity, types, postoperative complications and prognosis during the COVID-19 pandemic and to explore possible influencing factors.

METHODS

A total of 422 patients were enrolled in this study, and hospitalization and short-term follow-up data were retained. The patient population included 273 men and 149 women. Patients had a median (IQR) age of 54 (45-62) years and were divided into an observation group (130) and a control group (292), primarily according to severity of disease, disease types, baseline indexes, biochemical indexes, cardiac function indexes, complications and prognosis.

RESULTS

During the COVID-19 pandemic, compared with the same period last year, there was a significant increase in patients with aortic dissection (27.69% vs 5.82%), a significant decrease in patients with valvular heart disease (43.08% vs 66.78%), and significantly increased emergency admission (50.00% vs 21.23%) and severity (54.62% vs 27.40%). Family company (76.37% vs 64.62%) was decreased, EuroSCORE [6.5 (2-9) vs 2 (0-5)] score, Pro-BNP [857.50 (241.00-2222.50) vs 542.40 (113.45-1776.75)] ng/L, six months mortality rate (18.46% vs 8.90%), and postoperative complications, including infected patients, atelectasis, pulmonary edema, and so on were increased, with longer length of stay in the ICU and hospital in COVID-19 pandemic. Survival analysis curve further demonstrated that it had an impact on the deaths of patients during the COVID-19 pandemic period. Through ROC analysis of the death factors of patients, it was concluded that Family company affected the death of patients, and the area under the curve was 0.654 (P < 0.05).

CONCLUSIONS

In this study, we found that the admission rate of critically ill patients with cardiovascular disease, complications of cardiac surgery, and short-term mortality of patients all exhibited a short-term increase, family company may be a risk factors for short-term mortality, that may be related to public pressure caused by the COVID-19 pandemic.

摘要

目的

本研究旨在评估 COVID-19 大流行期间心血管疾病严重程度、类型、术后并发症和预后的变化,并探讨可能的影响因素。

方法

共纳入 422 例患者,保留住院和短期随访数据。患者人群包括 273 名男性和 149 名女性。患者中位(IQR)年龄为 54(45-62)岁,并根据疾病严重程度、疾病类型、基线指标、生化指标、心功能指标、并发症和预后主要分为观察组(130 例)和对照组(292 例)。

结果

与去年同期相比,COVID-19 大流行期间主动脉夹层患者显著增加(27.69%比 5.82%),瓣膜性心脏病患者显著减少(43.08%比 66.78%),急诊入院率显著增加(50.00%比 21.23%),严重程度显著增加(54.62%比 27.40%)。家庭公司(76.37%比 64.62%)下降,EuroSCORE[6.5(2-9)比 2(0-5)]评分、Pro-BNP[857.50(241.00-2222.50)比 542.40(113.45-1776.75)ng/L]、6 个月死亡率(18.46%比 8.90%)、术后并发症如感染患者、肺不张、肺水肿等均增加,COVID-19 大流行期间 ICU 和医院的住院时间延长。生存分析曲线进一步表明,COVID-19 大流行期间对患者死亡有影响。通过对患者死亡因素的 ROC 分析,得出家庭公司影响患者死亡,曲线下面积为 0.654(P<0.05)。

结论

本研究发现,心血管疾病危重症患者入院率、心脏手术并发症及患者短期死亡率均呈短期增加,家庭公司可能是短期死亡率的危险因素,这可能与 COVID-19 大流行引起的公众压力有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07a2/8720206/99441c686341/13019_2021_1744_Fig1_HTML.jpg

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