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2019年冠状病毒病大流行对慢性阻塞性肺疾病患者心脏手术的使用及预后的影响

Impact of the COVID-19 Pandemic on the Use and Outcomes of Cardiac Procedures in COPD Patients.

作者信息

de Miguel-Diez Javier, Jimenez-Garcia Rodrigo, de Miguel-Yanes Jose M, Hernández-Barrera Valentin, Carabantes-Alarcon David, Zamorano-Leon Jose J, Noriega Concepción, Lopez-de-Andres Ana

机构信息

Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28007 Madrid, Spain.

Department of Public Health and Maternal & Child Health, Faculty of Medicine, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain.

出版信息

J Clin Med. 2022 Jul 5;11(13):3924. doi: 10.3390/jcm11133924.

Abstract

(1) Background: The aim of this study was to assess the effects of the COVID-19 pandemic on the use and outcomes of cardiac procedures among people with chronic obstructive pulmonary disease (COPD) in Spain. (2) Methods: We used national hospital discharge data to select patients admitted to hospital with a diagnosis of COPD from 1 January 2019 to 31 December 2020. (3) Results: The number of COPD patients hospitalized in 2019 who underwent a cardiac procedure was 4483, 16.2% higher than in 2020 (n = 3757). The length of hospital stay was significantly lower in 2020 than in 2019 (9.37 vs. 10.13 days; = 0.004), and crude in-hospital mortality (IHM) was significantly higher (5.32% vs. 4.33%; = 0.035). Multivariable logistic regression models to assess the differences in IHM from 2019 to 2020 showed Odds Ratio (OR) values over 1, suggesting a higher risk of dying in 2020 compared to in 2019. However, the ORs were only statistically significant for "any cardiac procedure" (1.18, 95% CI 1.03-1.47). The Charlson comorbidity index increased IHM for each of the procedures analyzed. The probability of IHM was higher for women and older patients who underwent coronary artery bypass graft or open valve replacement procedures. Suffering a COVID-19 infection was associated with significantly higher mortality after cardiac procedures. (4) Conclusions: The COVID-19 pandemic limited the access to healthcare for patients with COPD.

摘要

(1) 背景:本研究旨在评估新冠疫情对西班牙慢性阻塞性肺疾病(COPD)患者心脏手术的使用情况及手术结果的影响。(2) 方法:我们利用全国医院出院数据,选取了2019年1月1日至2020年12月31日期间因COPD诊断入院的患者。(3) 结果:2019年接受心脏手术的COPD住院患者有4483例,比2020年(n = 3757例)高出16.2%。2020年的住院时间显著低于2019年(9.37天对10.13天;P = 0.004),且粗住院死亡率(IHM)显著更高(5.32%对4.33%;P = 0.035)。评估2019年至2020年IHM差异的多变量逻辑回归模型显示比值比(OR)值超过1,表明2020年的死亡风险高于2019年。然而,OR值仅在“任何心脏手术”方面具有统计学意义(1.18,95%可信区间1.03 - 1.47)。查尔森合并症指数增加了所分析的每种手术的IHM。接受冠状动脉搭桥术或心脏瓣膜置换术的女性和老年患者的IHM概率更高。感染新冠病毒与心脏手术后显著更高的死亡率相关。(4) 结论:新冠疫情限制了COPD患者获得医疗服务的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa8d/9267656/da8b70097ac9/jcm-11-03924-g001.jpg

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