Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
BMC Anesthesiol. 2024 Mar 9;24(1):98. doi: 10.1186/s12871-024-02445-5.
To evaluate the postoperative morbidity and mortality of patients undergoing cardiovascular surgery during the 2022 nationwide Omicron variant infection wave in China.
This retrospective cohort study included 403 patients who underwent cardiovascular surgery for the first time during the 2022 wave of the pandemic within 1 month. Among them, 328 patients were preoperatively diagnosed with COVID-19 Omicron variant infection during the pandemic, and 75 patients were negative. The association between Omicron variant exposure and postoperative prognosis was explored by comparing patients with and without COVID-19 exposure. The primary outcome was in-hospital death after cardiovascular surgery. The secondary outcomes were major postoperative morbidity, including myocardial infarction (MI), acute kidney injury (AKI), postoperative mechanical ventilation hours, ICU stay hours, and postoperative length of stay. The data were analyzed using inverse probability of treatment weighting (IPTW) to minimize bias.
We identified 403 patients who underwent cardiovascular surgery, 328 (81.39%) had Omicron variant infections. In total, 10 patients died in the hospital. Omicron variant infection was associated with a much greater risk of death during cardiovascular surgery after adjustment for IPTW (2.8% vs. 1.3%, adjusted OR 2.185, 95%CI = 1.193 to 10.251, P = 0.041). For major postoperative morbidity, there were no significant differences in terms of myocardial infarction between the two groups (adjusted OR = 0.861, 95%CI = 0.444 to 1.657, P = 0.653), acute kidney injury (adjusted OR = 1.157, 95%CI = 0.287 to 5.155, P = 0.820), postoperative mechanical ventilation hours (B -0.375, 95%CI=-8.438 to 7.808, P = 0.939), ICU stay hours (B 2.452, 95%CI=-13.269 to 8.419, P = 0.660) or postoperative stay (B -1.118, 95%CI=-2.237 to 1.154, P = 0.259) between the two groups.
Perioperative COVID-19 infection was associated with an increased risk of in-hospital death among patients who underwent cardiovascular surgery during the Omicron variant wave of the pandemic.
评估 2022 年中国新冠病毒奥密克戎变异株流行期间行心血管手术患者的术后发病率和死亡率。
本回顾性队列研究纳入了 403 例在流行期间行首次心血管手术的患者，其中 328 例在术前被诊断为新冠病毒奥密克戎变异株感染，75 例为阴性。通过比较有和无新冠病毒暴露的患者，探讨奥密克戎变异株暴露与术后预后的关系。主要转归为心血管手术后院内死亡。次要转归包括心肌梗死（MI）、急性肾损伤（AKI）、术后机械通气时间、ICU 入住时间和术后住院时间。采用逆概率处理加权（IPTW）法分析数据，以尽量减少偏倚。
共纳入 403 例行心血管手术的患者，其中 328 例（81.39%）感染了奥密克戎变异株。共有 10 例患者在院死亡。调整 IPTW 后，奥密克戎变异株感染与心血管手术后院内死亡风险显著增加相关（2.8%比 1.3%，调整 OR 2.185，95%CI=1.19310.251，P=0.041）。两组在心肌梗死（调整 OR=0.861，95%CI=0.4441.657，P=0.653）、急性肾损伤（调整 OR=1.157，95%CI=0.2875.155，P=0.820）、术后机械通气时间（B=-0.375，95%CI=-8.4387.808，P=0.939）、ICU 入住时间（B=2.452，95%CI=-13.2698.419，P=0.660）或术后住院时间（B=-1.118，95%CI=-2.2371.154，P=0.259）方面无显著差异。
在新冠病毒奥密克戎变异株流行期间行心血管手术的患者中，围手术期新冠病毒感染与院内死亡风险增加相关。
